When Dennis Disch, MD, thinks about physician leadership, he does not start with titles, organizational charts or boardrooms. He thinks about that patient who agreed to open-heart surgery after a careful evaluation—and then experienced a preventable adverse outcome.
For Dr. Disch, that moment clarified why leadership matters: Physicians can do everything right in the exam room and still see patients harmed when the larger system falls short.
“What really struck me is I could control everything about my patient's care up to a point. But then, I was turning them over to cardiac surgery, and I had no control over that,” said Dr. Disch, Advocate Health’s vice president for hospital-based specialties, Illinois and Wisconsin divisions.
He realized he wanted broader influence over quality and safety beyond his own exam room.
The next generation of clinical leaders will need emotional intelligence, operational fluency, data literacy and the ability to bring others along. And they will also need health systems to create the conditions for leadership: mentorship, protected time, meaningful exposure to enterprise strategy and pathways.
Leaders from Advocate Health, Jefferson Health, Northwell Health, Ochsner Health and Sutter Health drove home these messages during the Becker’s Healthcare 16th Annual Meeting in Chicago. Each organization is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Across sessions, physician executives described leadership as a skill that health systems must intentionally build—not something to expect physicians to figure out after being promoted. They also described a changing leadership mandate in healthcare.
Identify future physician leaders early
Identifying and preparing physicians before they assume formal roles is key. California-based Sutter North Medical Group starts thinking about leadership potential early, even during recruitment.
When hiring physicians out of residency, “we're looking for people who have interest—or potentially have interest—in taking on some leadership role down the road, whether it's five years or 10 years,” then provide the tools to support that development, said Steven Blair, MD, Sutter North’s president and chief executive officer.
Flexibility, being strategically adaptable and able to respond to change, is one of the most important qualities for future physician leaders. Just as important are strong interpersonal, or “soft,” skills. Leaders also need education in financial stewardship and the ability to understand and communicate effectively across the organization.
Sutter Health has structured programs—ranging from foundational courses to leadership academies and executive development opportunities—that help build those skills. These programs are most effective because of the strong partnership between the health system and the medical groups, Dr. Blair noted.
Physicians are already highly trained in quality and performance measurement. The bigger gap is often in understanding the financial side of the business: What you might call the “MBA language,” he said. At Sutter Health, the focus is on helping physicians build that knowledge, along with leadership and communication skills.
Compensation and workload also matter. As physicians take on leadership roles and reduce clinical time, models need to reflect both responsibilities. Dr. Blair spends about 30% of his time in clinical work. Leadership fills the rest.
“It really is a commitment,” he said.
Ultimately, only a small number of physicians will choose this path, so it’s important to identify, support and engage them early, Dr. Blair added.
Meeting physicians where they are
Leaders need to “keep the pulse” on physicians, understand what is hurting or helping them, and meet practices where they are. Sandy Balwan, MD, chief medical officer for Northwell Direct and senior vice president and executive director for Northwell Health IPA, emphasized this point in discussing the quality and safety application of leadership.
If you give physicians tools they can’t or won’t use, you’ll lose them, said Dr. Balwan. Northwell Health’s network, which spans New York and Connecticut, includes practices with varying levels of digital integration. Therefore, their approach is to deliver information in the format each physician needs, whether through customized reports or fully integrated digital tools.
Timely feedback is also important—annual scorecards are not enough. Physicians need frequent, actionable feedback so they can adjust in real time and stay engaged throughout the year, she said. Northwell Health, for example, implemented a tiered system that evaluates physicians based on quality, engagement and interoperability.
By working closely with physicians at each level and supporting their progression, “we’ve seen about a 21% improvement shifting tiers up and across providers,” Dr. Balwan said. Those tiers are tied to incentives, so as physicians improve, their compensation increases.
Collaborating across divisions
Physician leaders also need enterprise-level exposure so they do not get “left behind” in large health systems, noted Dr. Disch of Advocate Health. Quality standards only work when leaders understand the actual practice environment and align incentives, tools and feedback.
But purpose alone isn’t enough. The most effective leaders also have an insatiable drive to innovate—to leverage new technologies and tools to build better systems and deliver safer, higher-quality care, he said. In terms of development, one of the most valuable experiences is exposure beyond your physician specialty.
In a large, integrated system, that means collaborating across regions, service lines and functions.
Dr. Disch encouraged physician leaders to engage at the enterprise level—building relationships in areas like IT and revenue cycle—so they have a voice in systemwide decisions and can help shape how care is delivered across the organization.
Fixing what’s broken first
Judd Hollander, MD, senior vice president and chief virtual care officer of Jefferson Health in Philadelphia offered that leaders must accept failures and focus on what is broken, not just what is working.
In tennis doubles, you don’t win because of your strongest player—you lose because of your weakest. Healthcare is the same, he emphasized. “We need to bring up the weakness in our system and not concentrate on the strengths of our system.”
Dr. Hollander tied this patient access and capacity, arguing that patients want healthcare—not necessarily a specific visit format—and that virtual care can help redesign capacity around patient needs.
“We’ve heard a lot about artificial intelligence, but we could also use a little more natural intelligence—common sense—building a system for the patient,” he said.
Jefferson Health has been developing a model where physicians at capacity can spend a day a week doing virtual care from home, while another clinician sees patients in the office.
“That allows us to backfill them with another clinician … or a physician who could then see patients in the office to grow their practice,” Dr. Hollander said.
This isn’t just about having a virtual care strategy. There should be a patient care strategy, and virtual care is just the enabler. If you’re starting with the technology instead of the problem, you’re already off track, he said. The focus is to build scalable, standardized solutions. It isn’t about “tele-cardiology” or “tele-pulmonary,” it’s about connecting patients to providers, wherever they are. That only works with strong governance, tight collaboration, and clear workflows.
To make this happen, Dr. Hollander’s team created eight “SWAT teams” to synchronize operations and technology. Each team includes leaders from virtual care, nursing and medical informatics, and information systems and technology, along with a project manager. They meet every two weeks as needed and use checklists and defined workflows to make sure they’re not missing anything important.
You can’t have a “choose-your-own-adventure” approach with multiple platforms. It has to be unified, Dr. Hollander emphasized. If a clinical team comes to you with a need, you want to be able to solve it quickly and consistently. That’s what a mature virtual care model should offer, he said.
Learning from unlikely places
Visionary leaders don’t assume innovation only flows from large U.S. systems outward. They look for ideas wherever people are solving hard problems. For Eric Cioè-Peña, MD, MPH, vice president for global health at Northwell Health’s Center for Global Health, leadership goes beyond the walls of the healthcare institution.
“I focus on global health,” said Dr. Cioè-Peña, who’s trained in emergency medicine. While that may seem out of place at a Becker’s Healthcare conference, “there’s a lot of things we can learn from the global health sphere.”
This isn’t about short-term medical missions, but long-term partnerships that can produce lessons applicable back home, he said. Instead of working in dozens of countries, Northwell brought its focus to a few deep collaborations, like those in Ukraine and Guyana, where it partners directly with governments to strengthen health systems.
What’s striking is how similar the challenges are: workforce shortages, behavioral health gaps and limited access to care, he said. In Guyana, for example, there are just eight psychiatrists for the entire country. This called for a new approach, using community health workers and lay counselors supported by specialists, to expand access, said Dr. Cioè-Peña.
What’s been most valuable is reverse learning. In many cases, resource-constrained settings are driving innovative, scalable solutions that Northwell Health can adapt to improve care in its own systems, he said. Some of the solutions developed abroad, such as using trained community members, are now being applied back home in places like Long Island.
The augmented intelligence (AI) and telemedicine conversation is happening in the international space. And in many ways, it’s accelerating faster in resource-limited settings. In places like Guyana, where communities are geographically isolated but connected by high-speed internet, Northwell Health is using synchronous video telemedicine, AI and tools like Starlink to deliver real-time care across vast distances, he said.
Such expertise no longer has to be at the bedside, Dr. Cioè-Peña continued. With AI-assisted imaging and remote interpretation, you can bring high quality care to places that previously had little or no access.
Equally important is what this does for the workforce.
“The amount of inspiration and retention that we see with our staff being able to interact on a daily or weekly basis with international partners has been tremendous,” he said.
Stepping up during challenges
Lisa Birdsall Fort, MD, MPH, an emergency physician at Ochsner Health, took risks to shape her own leadership path. When an opportunity presented itself to move from a traditional operational physician leadership journey to writing her own job description, she took it, even though it was a more risky path forward.
“For me, it was about creating my own path based on the needs of our patients and the organization rather than working within the framework that previously existed,” she said. Dr. Fort is vice president of virtual care transformation at Ochsner, which serves Louisiana, Mississippi and the Gulf South.
She’s never been very good at saying no—and in many ways, that’s been a blessing.
A defining moment for Dr. Fort was during the aftermath of Hurricane Katrina, who at the time was a third-year medical student at Louisiana State University School of Medicine in New Orleans.
“I just went in with my short white coat and I was like: ‘Look, I'll carry water. I'll do whatever you guys need. I'm here to help.’ And they said, ‘You see those 2,000 people over there? There are some supplies. Do what you can.’ We just saw patient after patient and did what we could with what we had.”
It reinforced a mindset she’s carried ever since: When there’s work that needs to be done, you step up. It’s how she’s approached every leadership role—whether in operations, quality or informatics. Following the problems that need solving, even if it means learning entirely new skills along the way.
Ultimately, leadership is about responsibility. It’s about modeling behavior, developing others and understanding that different people bring different strengths. It’s the leader’s job to recognize that, support it, and build teams where people can succeed, she said.
“It’s really important to study the art and science of management and working with other people. People are going to have different strengths and weaknesses. They're going to have different leadership styles. Yours is not the only way, and frankly, often it may not be the best way,” Dr. Fort said. “Recognizing that and training and empowering your team to lead in their own way is a force multiplier.”
