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Getting up to bat. (Career Management).

Sports analogies are commonly used to accurately portrary otherwise complicated concepts. For instance, getting up to bat is an image that readily conveys the idea of making a bid for career advancement. If you play ball but don't get to bat, you don't get to bat, you don't have an opportunity to score.

This came to mind after I reviewed a recent issue of The Physician Executive that focused on a range of perspectives about how MDs can become CEOs (The Physician Executive, September/October, 2002, Vol 28, Issue 5).

Although this trend has been heralded for years, the truth is that CEO/MDs remain a small minority in this country. In fact, the number of CEO/MDs has not substantially risen in the past 10 year or so.

There are many reasons for this lag in CEO development for pysician executives. Nevertheless, I believe there will be more CEO/MD appointments in health care facilities throughout the country in the future. Will you be ready to go to bat when the time comes?

Parallels to earlier times

Here's why I'm predicting a sizable growth in CEO/MDs with such confidence: the market is speaking. CEO search committees are beginning to ask for qualified physicians to be presented as candidates for the job.

It's similar to the situation 10 or 15 years ago when these same health care organizations were seeking to hire their first real physician executives. By identifying physicians for full-time roles at the VP level, they were taking a big step away from their previous formula that typically consisted of hiring an older, retired physician to work part-time as medical director.

At first, these search committees were more traditional. They said they wouldn't not interview physicians with business credentials for the VP position. In a few years, their stance changed--they definitely wanted to see MD/MBA candidates (or their equivalents) and asked that they be included in slates.

Finally, in recent years, the business/management background or credential became a strong preference in candidates for VPMA positions. Job specifications almost always indicate. "formal business education preferred" in searches for physician executives.

Hiring pattern evolves

That same hiring pattern is shaping up for the CEO/MD. Again, for many years search committees and boards declared that they wouldn't not interview physician executives for the CEO position if qualified individuals were included in the candidate slate.

In more recent times, boards and CEO search committees have been asking to see qualified physician executives for their CEO role. And it's clearly just a matter of time until "physician preferred" is stipulated in the search specifications. (Of course, a small number of academic organizations, largely in the Northeast, mandated the CEO must be a physician for many years.)

Boards and CEO search committees are looking for leaders who can take their health care organizations on to greater success and achievement. And, increasingly, they are ready to accept the leadership of proven physician executives as appropriate and relevant for their organizations. They value these successful physician executives' vision and strong relationship skills as vital traits for success.

Batter up

Obviously, your first step is to get in the game. But to become CEO, you'll have to show you can hit home runs. It's essential that you get to the plate ready to bat. Here are three practical suggestions on how you can prepare for your career at-bat:

1. Acquire operations experience.

I can't say it often enough: if your career goal is to lead a health care organization, you must have operations experience. It is not optional. Boards will respect your physician-related leadership abilities but they will also expect you to have a working knowledge of actual operations.

This does not necessitate your becoming a COO--an unlikely career move for most physician executives. However, it does demand that you search out and capitalize on any operations opportunities that may come your way.

For example, you can develop clinical operations experience by heading an ambulatory care center or having departments such as medical records, pathology and radiology report to you. Many physicians now hold the title of EVP, which can encompass diverse organizational responsibilities. Complex health care systems offer more of this type of opportunity.

2. Aim a notch lower.

There's no easy way to say this, but many physician executives have an inflated sense of their capabilities. We're trained to be confident. However, this is an area in which it's best to start out more modestly and grow. Aim a notch lower than your first instinct indicates. Once you prove yourself in one situation, you can transition to a larger set of responsibilities.

The failure rate is far less for those who are willing to be humble at the start. And remember, even the best batters miss two out of three times.

3. Join an organization with a future.

You cannot predict with certainty, but your chances of ultimate success are much better in an organization that has a future. Choose to work in the health care system that has aspirations about where it's going and what it wants to accomplish.

If you're doing great work in the right organization, you will likely have many opportunities for career development. Many of the CEO/MDs I know were promoted to the top spot from their role as CMO or EVP--just as COOs have traditionally been promoted to CEO from within.

Don't take a job merely for a good title or because of status; look hard at the organization, and if it is a quality organization with a future, leap at it.

I know a physician executive who was sorry that he didn't listen to that advice. He went with an organization for the job level, but quickly realized he didn't fit in the environment. He bided his time and sought a way out.

It took him a couple of years to find another opportunity and again he asked for advice and counsel. I told him: "I rarely hear about the (new) organization, but whenever I do hear, it is good. Take the job." He did and he's happy now. He's on track for greater responsibility. And who knows? He may be tapped for CEO someday. It could happen.

CEO/MDs come of age

The role of the CEO evolved dramatically over the past years, now offering major organizational and political challenges, along with operations. Finesse in relationships with physicians and strategic market understanding are now considered keys to success. Those are usually particular strengths of many physician executives, who are ideally positioned for new leadership roles.

When a board today names a CEO/MD to lead the organization, it is affirming the recognition of the value the physician executive brings in these spheres of influence. The pool of qualified candidates continues to grow and I have every expectation that CEO/MDs are on the increase.

Be sure you're up to bat and ready to hit that home run when your time comes.

Mary Frances Lyons, MD, is a senior consultant at Witt/Kieffer in St. Louis. She can be reached by phone at (314)862-1370, or by e-mail at
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Author:Lyons, Mary Frances
Publication:Physician Executive
Geographic Code:1USA
Date:Jan 1, 2003
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