Caring for the business
Despite the benefits of clinician leadership long appreciated by organizations such as Mayo Clinic, most hospitals remain run by professional managers. As of 2014, just 5% of hospitals were run by physicians, according to the American College of Physician Executives.
“There’s a lag in terms of known statistics,” says Peter Angood, MD, president and CEO of the American Association of Physician Leadership (AAPL) in Tampa, Florida. “What we do know is there’s a strong desire from hospitals and health systems to have clinicians become more involved in the C-suite and as CEOs.”
Allegheny Health Network (AHN), a Pittsburgh-based integrated health system with seven hospitals and numerous outpatient sites across Erie and western Pennsylvania, is a prime example of a system making distinct changes along these lines.
In mid-2016, AHN announced a leadership overhaul in which physicians Jeffrey Cohen, MD, and Mark Rubino, MD, MMM, were promoted to president of flagship Allegheny General Hospital in Pittsburgh and president of Forbes Hospital in Monroeville, respectively.
Later that year, Louise Urban, RN, took on expanded leadership opportunities as president and CEO of both Canonsburg and Jefferson Hospitals, overseeing operations in a large geographic region south of Pittsburgh. Around the same time, Marcee Radakovich, DNP, RN, continued her rise through AHN leadership ranks to become vice president of operations.
Claire Zangerle, MSN, MBA, RN, on the other hand, joined AHN as a newcomer to become the system’s first chief nurse executive. “We are excited about the impact she is already having in developing a global strategy for nursing at AHN, focused on recruitment and retention, and redesigning our care pathways,” says Cynthia Hundorfean, MBA, AHN president and CEO.
Throughout the system, a total of 12 physicians and nurses now hold executive roles, says Hundorfean, who joined AHN in February 2016, after an extensive tenure in administration at the Cleveland Clinic.
Hundorfean’s administrative experience at the Cleveland Clinic instilled in her an appreciation for clinician leadership, and she was clear about her intentions to replicate her former employer’s traditional governance model at the outset of her new presidency.
“The whole objective was to have the voice of the clinicians within the network at the table when we were making decisions,” she says.
On an even deeper level, she sought to incite a philosophical shift among the network’s caregivers. “I really wanted the physicians to care about the health and well-being of the organization as much as they did their patients,” she says. “At the end of the day, the patient is coming to see the clinician, not the administrators. So in order to make a quick change in a health system, you need to have the physicians on board. And when I arrived at [AHN] a year ago, I found that there weren’t enough clinicians with seats at the table.”
Meanwhile, executive recruiters report increased demand for (and upon) clinical leaders throughout the industry.
“There are so many organizations looking for these people,” says Linda Komnick, a senior partner and co-practice leader with executive search firm Witt/Kieffer’s Physician Integration and Leadership practice. “We used to have between eight and 10 candidates for these types of positions. Now I’d say we have three to five, and they’re each looking at several opportunities,” she says.
There are a number of reasons why the candidate pool is small, Komnick adds. “The demand for physician leaders has grown as organizations are looking for individuals to oversee initiatives aimed at clinical integration, population health, and alignment and engagement of both employed and independent physicians,” she says. “In the pipeline there is a dearth of physician leaders who have the tools to take on these roles. We’re starting to see that change as younger physicians become interested in administrative roles early in their careers, but it will take years to bridge the chasm between the number of physician leaders required and those prepared to take on these roles.”
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.