How to Become a Physician Hospital Executive

By John Jurica MD
Shortly after finishing my residency, I worked in a small family medicine practice. I held inpatient privileges, and spent many hours in the local community hospital caring for my patients. As a result, I attended many medical staff committee meetings. I balanced work in the office, nursing homes, and the hospital for a long time. I enjoyed working in the hospital environment.
Ten years later, I was hired as Vice President for Medical Affairs, the hospital’s first ever physician executive. I was later promoted to Senior Vice President / Chief Medical Officer (CMO), and I stopped all direct patient care.
In the next few paragraphs, I’m going to explain how to make the transition from practicing clinician to hospital executive, based on my experiences and conversations with CMO colleagues.
Characteristics of an Emerging Hospital CMO
Physicians best suited to this career generally have the following characteristics or backgrounds:

• Enjoy working on teams and attending and running meetings;
• Interested in improving the health of populations of patients;
• Affinity for reading financial reports, working on QI projects, and starting new service lines;
• Trained in a hospital-based specialty such as: hospital medicine, anesthesia, surgery, cardiology, pulmonology/intensive care medicine, or emergency medicine.
  

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Why Seek a Leadership Position?
Working as a hospital executive enabled me to make measurable improvements in cohorts of patients. I relished the sense of accomplishment I felt by working on quality improvement and patient safety teams. The opportunities for advancement are excellent. Besides, the job payed much more than I could earn as a primary care physician.
The demand for hospital physician executives is rising, as are the types of jobs. Today you can find physicians in C-suite positions with roles beyond that of CMO, including, chief quality officer (CQO), chief clinical officer (CCO), chief medical information officer (CMIO), or chief patient safety officer (CPSO), and even as chief operating officer (COO) or CEO.
Steps to an Executive Career
The process of moving from clinician to hospital executive requires three major components:

• Demonstrating your interest and commitment;
• Acquiring and demonstrating the necessary knowledge, skills and experience; and,
• Convincing someone to hire you.

Unpaid Management Opportunities
I demonstrated my interest and gained management skills by volunteering on hospital-based committees and teams. The most meaningful experiences come when serving as chair of such committees. Here are a few examples:

• Medical Staff Department
• Quality Improvement Committee
• Pharmacy and Therapeutics or Formulary Committee
• Credentialing Committee
• Continuing Medical Education Committee
• Service Line Committees (Cath lab, Imaging, Laboratory, etc.)
  

Management Courses
To enhance your education, attend leadership and management courses presented by the American Association for Physician Leadership (AAPL), the American College of Healthcare Executives (ACHE), or the Greeley Company. Attend courses addressing:

• Financial Analysis and Reporting
• Negotiation
• Healthcare Law
• Measuring and Managing Quality
• Population Health
• Leading and Managing Physicians

More Management Experiences with Paid Positions
I further demonstrated my interest and enhanced my skills by working in a series of part-time paid positions while still practicing:

• Physician Advisor for Utilization Management
• Medical Director for a Family Planning Clinic
• Medical Director for an Occupational Medicine Clinic

Additional Experience on Nonprofit Boards
I gained additional experience running meetings, participating in major projects, and analyzing financial reports by serving on:

• Hospital Board of Directors
• Hospice Board, and Finance and Quality Committees
• County Board of Health

Serving as chair of the hospice and health boards were particularly useful in learning about annual budgets, financial reports, and working with other leaders.

Universal Tactics
Here are other helpful tactics to use concurrently:

• Find and use mentors. I had two excellent mentors, one a physician leader, the other a hospital CEO.
• Create a complete LinkedIn profile. This is more important today than ever.
• Join the AAPL. Take advantage of its business and management courses, career services, and job listings.
• Network. Reach out to colleagues, and former medical school classmates and co-residents, to find job openings.

Is a Business Degree Necessary?
At some point in the process, you might consider getting a business degree, such as an MBA, an MMM, (master's in medical management), or MHA (master's in health administration). But my advice is to get your foot in the door and then convince your employer to help fund the cost of the business degree.
Final Steps
The final part of the journey is to find opportunities and apply. A brief summary of that process is to:

1. Find openings by networking, and using recruiters (B.E. Smith, Cejka, Tyler & Co, etc.), the AAPL, and LinkedIn.
2. Do thorough research on the prospective health system and position being offered.
3. Prepare and send a cogent cover letter and resume, customized for each employer.
4. Rehearse for the interviews with a friend or coach.

Take this advice to heart, and follow this plan to land your first position as a hospital executive. The process may take a year or two to complete, but it's worth it.

About the Author: John V. Jurica, MD, MPH, is a certified physician executive, host of the Physician Nonclinical Careers Podcast and “admin” for the Physician Nonclinical Career Hunters Facebook Group. You can access a free guide to 3 Top Hospital Management Jobs, minicourses, and articles by going to vitalpe.net/nonclinicaldoctors.