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The start of any new year is a good time to reflect on where we've been and where we're heading. Physician executives have been at the helm throughout these turbulent times -- facing complex decisions, pivoting course, and charting new routes. Who are these leaders and how are they prepared for the job?

The American healthcare landscape has undergone a transformational change over the past two decades, and there has been a parallel evolution in the role of the physician executive. , a long-time colleague and trusted advisor in the field of healthcare executive recruitment, has had a front row seat as these changes occurred. Her thoughts and keen observations are well worth sharing.

In 2000, the typical physician executive was a clinical expert who focused on advancing best clinical practices. Often a renowned research leader in a specialty field, the traditional physician leader was a medical director who served as liaison between the hospital and the credentialed medical staff. Because quality and performance were key aspects of the role, it was important that these leaders be recognized by their peers as high-quality physicians.

By 2010, physician executive positions were being filled by "interdisciplinary pioneers" who promoted collaboration and multisectoral research initiatives, and approached health and patient care holistically. As the role became more complex, physician executives were often given the title of vice president of medical affairs.

As the healthcare landscape continued its metamorphosis, so did the role of the physician executive. The job description soon called for a trusted business executive with considerable administrative and financial obligations. By 2018, the position required a strategic partner with a firm understanding of business and healthcare -- an MBA degree was a real plus. Candidates were expected to show a track record of innovative and strategic leadership early in their careers (e.g., reimbursement/care models, health policy, community outreach). In addition to being respected by clinicians, the physician executive was expected to represent the views of all stakeholders and be adept at consensus building, effective communication and negotiation.

By the time 2020 rolled around, innovation was name of the game. In addition to research and clinical excellence, a physician executive had to demonstrate the ability to apply that expertise and expand thought leadership into patient/consumer experience, primary healthcare, digital health, and technology transfer/venture initiatives. The job had become onerous for even the most talented and energetic among us!

We all know what came next -- the unprecedented upheaval and irreversible changes that came about as a result of the pandemic. The post-pandemic healthcare delivery system will continue to evolve rapidly. What are the implications for "who's at the helm"?

The post-pandemic era will require a new type of physician leader, one who can refocus our attention on performance improvement and inspire the sweeping organizational changes. Yes, we need innovative leaders with additional skill sets including expertise in digital health, technology transfer, and a deeper understanding of the role of private equity in healthcare. But we also need leaders who are sensitive to diversity, inclusion and, most importantly, reducing disparities and inequities in care. There couldn't be a better time to seek physician executives from different backgrounds, cultures, and other demographics.

The requisite skills are not readily acquired in the course of clinical training. However, there are a number of well-established leadership training programs for physicians, including:

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Programs like these will help equip physician executives to better meet today's multitude of challenges.

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