Defining the Physician Administrator
In the past several years, health systems have experienced an increasing number of physicians transitioning to leadership roles that extend beyond patient care.1 This trend is largely driven by a need for healthcare administrators who can bridge the gap between clinical acumen and organizational management while also navigating the rapidly evolving healthcare landscape. As value-based care, quality metrics, and patient satisfaction scores become increasingly tied to an organization’s success, physicians offer critical insights that non-clinical administrators lack.
A physician administrator is a physician who has transitioned from direct patient care to leading a service line, department, or entire health system. Physician administrators can fill various roles, such as medical director, division chief, chief quality officer or CQO, chief information officer or CIO, chief medical officer or CMO, and even president, or chief executive officer or CEO, of a medical group or healthcare system. In these roles, physician administrators participate in clinical operations, strategic planning, policy development, and quality improvement projects.
The physician administrator’s role is complex, requiring clinical knowledge, leadership skills, and the ability to navigate the intricate and ever-evolving healthcare industry. The best organizational leaders are often those who also understand what happens at the bedside. Hospitalists have prioritized patient care for years, listening attentively to patients, synthesizing complex information, and developing comprehensive care plans during sometimes arduous hospital stays. We understand the functions of individual organ systems, as well as how these systems interact with one another, and this ability to view patient care on multiple levels lends itself to the transition to understanding the health system on multiple levels. Hospitalist leaders shape policies, improve workflows, and manage diverse teams to ensure that excellent patient care leads to better results for the entire system. Given the thorough understanding of how the health system functions, hospitalists are uniquely positioned to drive change within the organization, both for patients and for clinicians. The frontline experience hospitalists bring to administrative roles connects systems thinking and the reality of direct patient care.
Leveraging Hospitalists’ Unique Skillset
Hospitalists thrive in the fast-paced environment offered in the hospital, where caring for acutely ill patients, communicating with team members, making complex decisions, and multitasking are part of every shift. This skillset, learned during work on the wards, makes hospitalists a natural choice for leadership roles. We are experts in engaging multidisciplinary teams, optimizing hospital throughput, and balancing patients’ clinical and social needs. These skills are precisely what is needed when transitioning into administrative roles when engaging with colleagues, department heads, and hospital administrators. Complex information is translated within the different contexts of reimbursement, documentation, and liability. As with a true internist, expertise is not gained in any single area; rather, familiarity with each is critical. Instead of approaching this transition as entirely new, we approach this transition as a shift in an existing skill set.
Hospitalists are inherently leaders on the wards, with nursing, patient-care techs, case managers, and social workers looking to us to set the tone for the day. We play a pivotal role in maintaining the culture and morale of the team. With administrative positions, this informal leadership becomes more formalized with higher expectations. We continue to lead by example, but now in a different setting in meetings and boardrooms, and we continue to advocate in respectful ways and to communicate in multiple forums and to different audiences with a broader impact.
Cultivating Essential Qualities
Regardless of whether a physician naturally embodies characteristics of a good leader or has diligently worked to develop skills over time, a leader must show authenticity and curiosity, be open to feedback from peers and mentors, and be able to view issues from differing perspectives. Physician leaders are creative, resilient, and empathetic, fostering relationships, building trust, and actively engaging with others.2 Great leaders are those who have taken time to reflect and learn their unique leadership style. Professional development tools such as the dominance, influence, steadiness, conscientiousness (DiSC®) assessment and the Thomas-Kilmann Conflict Mode Instrument can give a rising leader great insight into communication tendencies and conflict resolution preferences. Leaning on this information, hospitalists can recognize weaknesses and build upon their strengths, resulting in a more effective leadership style.
The leadership journey differs for each hospitalist. Many question whether to pursue an advanced degree, such as an MBA. While these degrees offer a valuable understanding of operations, strategy, and healthcare economics, they are not required for a leadership role, especially in the healthcare setting. Effective leadership is less about having a specific degree and more about emotional intelligence, communication skills, and the ability to inspire and motivate others. Several leaders utilize prior experiences, smaller leadership roles, mentorship, and professional development programs to develop the skills necessary to function as an effective leader. Most of this can be learned in practical settings and enhanced by conferences such as the Society of Hospital Medicine’s Leadership Academy, the American College of Physicians’ Leadership Academy, or numerous courses offered by the American Association for Physician Leadership and American College of Healthcare Executives. The value of building relationships, engaging with team members, and staying committed to a shared vision exceeds any credential. While an MBA or other advanced training program lends itself to a pathway to leadership, prior experiences and personality traits are what ultimately lead to success in the role.
Embracing the Challenges (and Opportunities!)
Transitioning from a physician to an administrator comes with a unique set of challenges, particularly when it comes to managing competing priorities. Physicians must learn to shift the scope of their practice from patient care and individual outcomes to larger, organizational concerns such as budget constraints and compliance regulations. Balancing the clinical aspects of patient care with the operational demands of leadership can be quite delicate. Physician administrators must maintain a balance between high-quality standards of care and financial sustainability, while also building a collaborative culture and meeting the needs of a diverse team. Developing skills in time management, delegation, and systems thinking is essential to effectively balance these competing demands.
These challenges also present opportunities. Hospitalists in administrative roles are in a unique position to influence hospital policies, streamline delivery of patient care, develop quality initiatives, and advocate for clinician wellness. Firsthand knowledge of how patient care is delivered allows for the development of practical solutions across the system. Physician administrators have the opportunity to find new meaning in their careers by shaping the system rather than simply functioning within what already exists. Witnessing how a decision made as an administrator impacts patient care, improves outcomes, and builds a positive work environment leads to personal growth and career satisfaction.
Conclusion
The healthcare industry benefits from physician administrators who drive meaningful change by linking their medical expertise with knowledge of quality improvement, healthcare finance, practice guideline development, and transitions of care. While navigating the journey from physician to administrator presents challenges, the impact of physician leaders in shaping policies, driving organizational change, and improving patient outcomes is indisputable. As the healthcare landscape continues to evolve, the role of physician administrators will remain essential in providing effective, patient-centered care.
Dr. Crecelius
Dr. Perrin
Dr. Engblade
Dr. Crecelius is an academic hospitalist and assistant professor of medicine at Indiana University School of Medicine in Indianapolis. Dr. Perrin is an academic hospitalist, a clinical associate professor of medicine, director of the hospitalist certificate program, and co-director of the generalist track at the University of Pittsburgh Medical Center in Pittsburgh. Dr. Engblade is the division chief of hospital medicine at the University of Kentucky in Lexington, Ky., and the chair of the SHM Academic Leadership Special Interest Group.
References
1. Gallagher, TM. Medical director and physician executive leadership survey. AJG website. https://www.ajg.com/news-andinsights/medical-director-and-physician-executive-roles-increase-nationally-in-number-and-complexity/. [Paywall] Accessed January 10, 2026.
2. Knight R. 8 Essential qualities of successful leaders. Harvard Business Review website. https://hbr.org/2023/12/8-essential-qualities-of-successful-leaders. Published December 13, 2023. Accessed January 10, 2026.