Becker's Clinical Quality & Infection Control

58 CLINICAL LEADERSHIP SPOTLIGHT Why demand for physician leaders is growing By Kelly Gooch A s a practicing OB-GYN in the 1980s, Lawrence Antonucci, MD, didn't necessarily aspire to become CEO of a health system. He said that was not a common career path for physicians at the time, except at top-performing organizations such as Cleveland Clinic and Rochester, Minn.-based Mayo Clinic, which have always been led by physicians. But Dr. Antonucci said he has increasingly seen more physicians in these leadership roles. "I think it became apparent that over time physicians with the right training and experience could learn a lot about hospital operations and bring with them that clinical experience and that front-line experience," said Dr. Antonucci, who has served as president and CEO of Fort Myers, Fla.-based Lee Health since June 2017. Increased interest in physician leaders Over the last two or three years alone, global executive search firm WittKieffer has seen an estimated 20 percent increase in hospitals and health systems wanting physicians included as candidates in their CEO searches. Linda Komnick, managing partner and practice leader in the physician integration and leadership division at the firm, attri- butes this trend in part to healthcare's shift from volume-based care, which focuses on the number of patients seen, to val- ue-based care, which focuses on care quality. WittKieffer con- ducts more than 400 healthcare executive searches annually, and about 15 percent of those are CEO searches. In the vast majority of CEO searches, hospitals and health systems are looking for physician leaders who've had experience in improving quality through managed care and population health. Ms. Komnick said that wasn't the case 15 years ago, when a physician would go to managed care, then face difficulty getting into health system leadership operations. Additionally, she's seen younger physicians increasingly seek MBAs and master's degrees in population health management to prepare for potential hospital and health system leadership roles. And she's seen quality committees of hospital and health system boards become even more important to organizations. "This is an exciting time for physician leaders. There is a wealth of opportunity out there," she said. "How do these people move up? You see people starting on committees, medical staff, [and] moving into more leadership roles such as CMO, chief physician executive, [then] taking on operational responsibilities, getting that seat at the table, involved in leading clinical strategy." Saul Weingart, MD, PhD, president of Providence-based Rhode Island Hospital and its Hasbro Children's Hospital, said in- creased employment of physicians by hospitals is another factor in the rise of physicians as hospital and health system leaders. Hospitals employed 44 percent of physicians in January 2018, up from 43 percent in January 2017 and 26 percent in July 2012, according to a 2019 study from the nonprofit Physicians Advo- cacy Institute and Avalere. From July 2012 to January 2018, the number of hospital-acquired physician practices also grew from 35,700 to 80,000, the study found. "When I started practicing years ago, physicians wanted to be left alone to do their job, and their ideal circumstances was where they had relatively few administrative burdens and could see patients," said Dr. Weingart. "But over time, increasingly folks have become employed, and instead of being solo operators and entrepreneurs, they've become part of corporate enter- prises. And I think there's a sense among many clinicians that it's helpful to understand the administrative challenges of the organization so you can play a role in overseeing and directing your own work." Still, he acknowledged that not all physicians see hospital and health system leadership as an interesting career opportunity, and that there are multiple pathways that can be taken by physi- cians who desire these positions. Leadership paths for two physicians Dr. Weingart's career started on the quality side of the industry, in research, and gradually moved to administrative roles. He said he started as a primary care physician in an academic setting and did research on quality and patient safety. "A lot of the quality improvement projects I did turned out to be important clinically because they improved patient experience or patient flow, or reduced medical errors and harm, so I was gradually able to take on more leadership roles in the quality area," said Dr. Weingart. He served as vice president for quality and patient safety at Da- na-Farber Cancer Institute in Boston, then as CMO and senior vice president of medical affairs at Boston-based Tus Medical Center and Tus Children's Hospital. He also was a professor of medicine, public health and community medicine at Tus University's medical school. He began his current role as president in February. For Dr. Antonucci, with Lee Health, the path toward leadership began as a practicing OB-GYN, then led to him co-founding Phy- sicians Primary Care, a large multispecialty physician practice in Florida's Lee County, in 1983. He became chief administrative officer of Lee Health's Cape Coral (Fla.) Hospital in 2007. He was appointed COO of hospital services for Lee Health two years later and took re- "This is an exciting time for physician leaders. There is a wealth of opportunity out there." - Linda Komnick, managing partner, WittKieffer

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