For Disruption of Health Care, They’re Off to a Good Start

While some believe managers do not necessarily need content expertise to lead an organization, the evidence argues for physician-led health care organizations.

In the Physician Leadership Journal field report “Filling Leadership Gaps for Medical Students,” Mulcare et al. describe an intensive eight-week program that exposes rising second-year medical students to the business side of medicine. They provide their Healthcare Leadership and Management Scholars with hands-on experience to influence future career decisions, including potential training in business skills and medical leadership.



The story: Medical students who want to be physician leaders often lack appropriate exposure to resources and training to allow them to develop the necessary skills. An innovative program addresses this void. Click here to read it.

On this page, Thomas L. Higgins, MD, MBA, CPE, a member of the Physician Leadership Journal editorial board and AAPL board of directors, comments on the report.

While some believe managers do not necessarily need content expertise to lead an organization, the evidence argues for physician-led health care organizations.1,2 But unless business exposure starts early, the aspiring physician leader might not have enough time to develop the necessary progressive experience in the field. Although noted author Malcolm Gladwell’s “10,000 Hour Rule”3 has been disputed, there is no question that thousands of hours are needed to achieve mastery of a domain, whether clinical or administrative. Weill Cornell Medicine’s program helps start the leadership clock at an early stage.

The value proposition for physicians has changed. Since antiquity, we have delivered direct patient care, a market that is now being disrupted by advanced practitioners, pharmacy chains and the internet. While patients and physicians value bedside interaction, the market has decided that physical encounters (such as examinations and procedures) are now commodities, and inevitably they will be priced as low as possible. Sharing the care via a team approach is one solution for cost-efficient delivery,4 but that requires changes in payment methodology to reward cognitive input and supervision as well as the physical encounter.

Arguably, physicians now add more value with their creative output, including supervision of direct care and streamlining the processes of health care delivery. Medical school, residency and fellowship train us for the bedside work. The business and organizational skills are either self-taught or obtained via master’s training, but they are not yet fully integrated into everyone’s career path.

Talent is fleeing medicine for other fields offering more autonomy, higher compensation and better job satisfaction. Physician leadership is more important now than ever if we hope to be happy working within the medical-industrial complex that has supplanted solo practice.

Tomorrow’s physicians must be prepared to take the leadership reins, and the Healthcare Leadership and Management Scholars Program is an encouraging start.

Thomas L. Higgins, MD, MBA, CPE, is a member of the Physician Leadership Journal editorial board and the American Association for Physician Leadership board of directors. He is an intensivist at Baystate Medical Center and chief medical officer for The Center for Case Management in Massachusetts.


  1. Porter ME, Teisberg EC. How physicians can change the future of health care. JAMA, 2007; 297:1103-1111.
  2. Stoller JK, Goodall A, Baker A. Why the Best Hospitals are Managed by Doctors, Dec. 27, 2016. org/2016/12/why-the-best-hospitals-are-managed-by-doctors. Retrieved Feb. 26, 2018.
  3. Gladwell, M. Outliers: The Story of Success. Boston, Little Brown, 2008.
  4. Higgins TL, Hodnicki D, Artenstein A. Sharing Care in the ACO Era. Am J Accountable Care, 2014: 9.14: 27-30


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