Recently, Columbia University’s president resigned after months of chaos, following in the footsteps of Harvard and my own institution, Penn.
Besides struggling with encampments, building takeovers, and commencement challenges, the three universities have something else in common: They have all chosen M.D.s as president or interim president.
Some people might be surprised by that. But I’m not.
I’ve trained more than 2,000 clinicians in leadership positions over the last 15 years. I’ve seen firsthand how clinical decision-making and experience in the trenches of a hospital can prepare a clinician to be an effective leader in medical as well as non-medical business settings.
Those heading to medical or nursing school gravitate there because they inherently want to better the lives of others. They must be exceptional students, mastering science, math, and literature. The combination of problem-solving skills and empathy for others is rarely a requirement in other professions. Nevertheless, it is a crucial special sauce for thriving as a leader.
Many other skills of doctoring are also relevant for business. Medicine is one of the few professions where clinicians are asked to lead organizations without much business training.
As patients, we like to think that our doctors are all-knowing scientists. But they routinely perform under significant uncertainty, incomplete information, time pressure, and high stakes. They work in an improvisational theater, where art and science, impressions and advanced technology, individualism and team approaches are holistically blended into outcomes that shape them as professionals and as human beings.
Most doctors do not realize that business leadership is fairly similar. Decisions often must be reached quickly without all the facts. It may not have the same life-or-death consequences, but business leadership can have definitive impact on financial and operational success, as well as employees’ jobs, self-worth, and their desire to work for your enterprise.
So, experiencing imposter syndrome is not uncommon, and I’ve seen how cathartic it is for doctors to realize how transferable their skills are. They often value listening and learn to distill key priorities from the noise. They’ve been battle-tested in critical decision-making, working long hours in stressful environments, interacting with people from all walks of life, and mentoring fellow doctors.
The physicians who make it to the top of universities have accumulated broad experience of which doctoring is just one part. Columbia’s Katrina Armstrong and Penn’s Larry Jameson both ran medical schools and large hospitals before ascending. Harvard’s Alan Garber has been an inspiration for me in becoming a health economist. He was a pioneer in coupling an M.D. with a Ph.D. in economics, becoming one of the first of his generation to defy specialization and connect seemingly unrelated fields. He also spent 12 years as Harvard’s provost before taking the top job.
Physician leadership is becoming the norm over time. Doctors are everywhere. Congress has seen a rise in their numbers with Rand Paul of Kentucky, John Barrasso of Wyoming, Roger Marshall of Kansas, and Bill Cassidy of Louisiana —all Republicans — serving in the Senate, and 15 physicians in the House.
It is important to understand that this phenomenon has both pull and push elements to it. Thus far we covered the pull: why clinical background makes one a better leader. But there are also push factors. Doctors, especially in primary care and family medicine, find their work to be increasingly driven by metrics that limit the time they can spend with patients. Job satisfaction is abysmal, burnout is common and rising. As a result, both physicians and nurses are in short supply.
These trends make doctors look around and realize they can do more to advance their passion for caring and improving population health while working for or even leading organizations like health insurers, device manufacturers, pharmaceutical companies, and consulting firms.
A close friend — an anesthesiologist by training who also served as a hospital executive — decided to join a consulting firm, where he helps transform health care delivery. He has given up seeing patients and no longer wears a white coat. But he has an enormous impact on patients, and he’s happy, energized, and productive.
The transition from patient care to organizational leadership presents a unique set of challenges for physicians. At the bedside, doctors are accustomed to direct, tangible impact on individual patients, a role that forms a significant part of their professional identity. Shifting to a leadership position, especially outside of health care settings, requires them to broaden their perspective, focusing on different stakeholders, operational efficiency, and strategic vision. This transition often necessitates the development of new skills in management, finance, and communication, areas not typically emphasized in medical training.
Moreover, physicians may grapple with the loss of the immediate patient interaction that originally drew them to the field, potentially leading to an identity conflict. Their reputation and credibility among peers, long built on clinical excellence, must now be re-established in the realm of leadership, where success is measured by different metrics. Balancing these new responsibilities while maintaining their medical ethos can be daunting, yet it is essential for those who wish to lead organizations effectively.
Physician leadership programs like the one I run at Wharton often highlight the relative advantage that clinical training can bring to leadership, as opposed to a reset, where one stops being a doctor and starts being an executive. The goal is to harness years of meticulous study and learnt experience for leadership that is built on knowledge, compassion, and vision. To accomplish that, our program at Wharton focuses on developing critical skills in three areas: leadership tools and expertise, business acumen, and essential context required to navigate a rapidly changing environment.
Doctoring outside the clinic is not for everyone. And as a society we must do a better job of making the work of clinicians more manageable, rewarding, safe, and satisfactory. But those who seek leaders for ailing organizations even outside of medicine may find that an M.D. is just, well, what the doctor ordered.
Guy David, Ph.D., is the Alan B. Miller professor of health care management at the Wharton School, a professor of health policy at Perelman School of Medicine, and senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.
