The majority of physicians in administrative leadership roles say they aspire to someday become a CEO, though there appears to be a disconnect between what CEO hopefuls, physicians who reached the top, and their organizations view as barriers to advancement, according to a new McKinsey report.
Pulling from 296 surveyed physician leaders as well as interviews with 50 physician and nonphysician healthcare executives, the firm’s report brings warnings that healthcare organizations may “be unintentionally reinforcing a cycle of exclusion—where physicians seen as unready for leadership are overlooked” for development opportunities.
The report’s authors recommended that organizations consider “a structured, meritocratic process to identify high-potential physician leaders” and to better understand the biases related to physician leaders that may surface during the CEO selection process.
As for the physician leaders themselves, McKinsey recommended aspiring CEOs to ask themselves if they are viewing the ladder climb “with humility and intention—assessing [their] capabilities against the needs of the next role, filling skill gaps, and seeking the most relevant mentors and coaches.”
McKinsey’s survey, fielded from March to May, polled healthcare and life science physician CEOs and physicians up to four levels below that title. For reference, about 15% of CEOs at these types of organizations are physicians.
Fifty-one percent of the polled physicians said their motivation to become a leader was primarily fueled by a desire to have a broader impact on patient care—just under a quarter cited improved compensation and financial success among their top motivators.
Among the 258 respondents who were not at the CEO level, 58% said they aspired to become a CEO someday. Twenty-six percent said they had no aspirations for the role.
“However, in our interviews, nearly all physician CEOs shared that they did not initially envision becoming a CEO, and many remained uncertain even when they were first considered for the role,” the report’s authors wrote. “This suggests the need to identify and nurture high-potential physicians regardless of their stated interest in the CEO role.”
Polled physician leaders broadly said they were confident they possessed several key business skills, including their ability to head up large teams and guide an organization’s operations and strategy. On the other hand, CEOs interviewed by McKinsey who were not survey respondents cited the same skills as a stumbling block for physician advancement.
When asked about barriers to advancement, physician leaders often pointed to perception barriers (named by 52% as a top three challenge) and institutional barriers (45%) as external factors, with gaps in skills and experience (60%) and training (52%) leading as intrinsic challenges.
Of note, there was limited overlap between the respondents who cited skills and experience gaps and perception barriers—though McKinsey warned that the high prevalence of physician leaders citing the latter is cause enough for institutional reflection.
As far as the development opportunities that can help overcome those barriers, respondents multiple tiers removed from the CEO role most often described on-the-job training (80%), degree programs (75%), executive education programs (65%) and informal mentorship (60%) as particularly effective. CEOs and those reporting directly to CEOs generally agreed, but placed substantially more weight on leadership fellowships, informal mentorship, peer coaching and networking than their earlier tenured counterparts.
“These findings highlight that leadership development should evolve as leaders advance, both in the types of skills and methods of acquiring those skills,” the report’s authors summarized. “Early in the transition to leadership, physicians benefit from degree programs to learn new skills not taught in clinical training and hands-on experiences to relearn and adapt their clinical skills to leadership. Later in the journey, relational means of learning grow in importance, as opportunities like mentorship, networking, and coaching help physicians learn how to lead themselves and others.”