The Exec: Physicians Mulling Administrative Roles Should Talk to People Who Have Walked That Path

To pursue administrative roles, physicians should seek out a mentor, the chief medical officer of West Penn Hospital says.

Before taking on an administrative role, physicians should consult with physician executives about their challenges, their keys to success, and the pros and cons of administration, says Beth Prairie, MD, MPH, chief medical officer (CMO) of West Penn Hospital.

Prairie has been CMO of the Pittsburgh-based hospital, which is part of Allegheny Health Network (AHN), since April 2021. She also has served as medical operations officer for AHN's Women's Institute.

HealthLeaders recently talked with Prairie about a range of issues, including the challenges of serving as CMO at West Penn Hospital, her main learnings from serving as a CMO during the coronavirus pandemic, and how her clinical background in obstetrics and gynecology helped prepare her for the CMO role. The following transcript of that conversation has been edited for clarity and brevity.

HealthLeaders: What are the primary challenges of serving as CMO of West Penn Hospital?

Beth Prairie: Coming in as chief medical officer during the coronavirus pandemic represented a specific set of challenges both for myself as a leader and for the hospital, the patients, and the health system. Coming out of the public health emergency and emerging into a world of an even worse nursing shortage and a general staffing shortage moved us into a second set of challenges that are ongoing.

HL: How are you rising to the staffing challenge?

Prairie: As a chief medical officer, I am responsible for overseeing the clinical quality of the care that we provide in the hospital. Under those auspices, I think of chief medical officers as being the head physician for the hospital. So, I think a lot about my physician workforce.

For physicians and advanced practice providers, we need to make sure we are addressing their needs from an employment perspective. We need to acknowledge the significant toll that the pandemic took on all of our frontline clinicians, including physicians. We need to support them as we move into a post-pandemic world.

We need to make sure that we are a hospital that is committed to patients and families first. We need to think about them first in every action that we take and every strategy that we implement, which will make us attractive for clinicians to come work with us.

Along the lines of quality and collaboration, all of us know that growing your own talent and supporting your own talent is the best way forward—certainly for recruitment and often for retention. I am fortunate to be at a teaching hospital, where we train the next generation of physicians. Nothing is a greater sign of success than when we can recruit our own residents and fellows to stay with us. We focus on making sure that we understand their needs and that they are supported in their education and clinical work. We try to have an environment of collegial collaboration that any physician would feel lucky to join.

Another thing that we often do not talk enough about is making sure that we do not leave anybody behind in our recruitment efforts. Part of being a collegial and collaborative healthcare environment is making sure that we treat each other with respect and that all people regardless of their characteristics are equally welcome to come to the table.

Beth Prairie, MD, MPH, chief medical officer of West Penn Hospital. Photo courtesy of Allegheny Health Network.

HL: You became CMO of West Penn Hospital in the middle of the pandemic. What were your main learnings from this experience?

Prairie: I learned to have flexibility in all things except ethics. We faced an unprecedented crisis in modern times, and it required us to be flexible. We needed to be flexible in thinking both as individuals and groups caring for patients. We needed to be flexible as a hospital and a network organization. The capacity to assess a problem and think of new ways to solve a problem was also critical to our success.

I also learned the importance of continuing to be kind to each other as we went through an unbelievably stressful situation.

Finally, I learned the importance of communication—communicating with each other, communicating with our patients, and communicating with our communities about risks and how to mitigate them.

HL: You have a clinical background in obstetrics and gynecology. How has this clinical background helped you serve in the CMO role?

Prairie: Part of West Penn Hospital's function in the community is that we provide the full range of women's healthcare services. More than 50% of the patients who are cared for at West Penn Hospital are here for something related to gynecology or obstetrics. It is important and useful to have physicians at the executive level who have a broad and deep understanding of how we provide care to women. For West Penn Hospital, it is important to have an OB/GYN leader who can communicate with our physicians and who understands all of the aspects of the care that we need to provide—from gynecologic surgery all the way through obstetrics.

HL: What advice would you offer to other female physicians who may be interested in an administrative leadership role such as CMO?

Prairie: The advice I always give to everyone who asks about being a physician executive or pursuing more of an administrative role is to talk with other people who have walked that path. Find out what their challenges have been. Find out what they feel gave them success in that pursuit. Find out about some of the downsides of pivoting from a primarily clinical role to a primarily administrative role. Like all things, there are pros and cons. You need to think about who you are as a physician—why you get up every day to do the work and how an administrative role will best serve you, patients, colleagues, and your community.

It is always helpful to have a mentor. Mentors can be hard to find, but if you have one, use them and talk with them. If you are interested in being mentored, seek a mentor out. It is helpful to have someone you can bounce ideas off of and someone you trust to reflect back to you honestly about your strengths, weaknesses, areas of opportunity for growth, and how the next step in your career path could be served best.

HL: How are physicians involved in administrative leadership at Allegheny Health Network?

Prairie: Allegheny Health Network is committed to being a clinician- and physician-run organization. For example, our hospital presidents are physicians. Our hospital presidents still see patients as do the chief medical officers. It is our belief that having physicians who are still active participants in patient care lead us as an organization informs our decision-making with the ethos of being a physician at the forefront.

Going back to recruitment and retention, you must be able to grow that bench. If you are committed to physician leaders, you must have structures in place to help interested or promising physicians to have the opportunity to try on administrative hats.

In each of our institutes, which function similar to clinical departments, there are officer roles for physicians to have the opportunity to both perform vital administrative functions in their home departments as well as at the network level. For example, I was the medical operations officer and the information technology officer for the Women's Institute prior to becoming chief medical officer at West Penn Hospital.

We also have a medical staff officer structure, which is an important part of how physicians take care of ourselves as professionals and operate on the hospital level.

So, there are multiple ways for physicians to get involved from a leadership perspective and learn multiple parts of the organization.

Related: The Exec: How to Successfully Lead a Large Medical Group