How health care organizations can set up chief medical officers for success

It should be obvious that medical school and clinical experience, in themselves, can’t fully prepare someone for the C-suite, any more than an MBA and corporate leadership experience equip someone to be a doctor.

But all too many health care organizations promote their best physicians to chief medical officer (CMO) on the assumption that they can pick up the new skills they need on the fly. And the CMOs themselves — who often have a record of success stretching back to kindergarten — don’t doubt that they can handle whatever their new role throws at them.

That is, until they realize that their authority and expertise are no longer unquestioned, and that they often have to persuade, rather than write orders for others to execute. Understanding the clinical need for a new multimillion-dollar imaging facility is one thing; understanding its business implications and incorporating it into the organization’s strategic plan is another.

Even physicians who seem like “naturals” at management can benefit from the training and mentoring that gives every manager the tools to develop business strategies, effective collaboration, and communication with both internal and external stakeholders. Ironically, executives who aren’t physicians may discount the value of their own expertise and assume that anyone who can survive medical school can pick up business skills as they go. Maybe, but it can be an expensive and inefficient way to learn.

We have experience from both sides of this equation. One of us, John, went through medical school and also pursued a master’s in public health as preparation for someday expanding into areas in addition to clinical care (a path that turned out to include stints at the FDA and the Discovery Channel before becoming CMO at WebMD). While earning that master’s was rewarding and useful, he now wonders whether he should have delayed or even passed on the master’s until his direction was clearer.

The other, Ranil, designs executive education programs for physician executives who are aspiring chief medical officers, and other clinical and non-clinical healthcare executives looking to build their leadership skills. Many of the participants pay for those programs out of their own pockets because they realize how urgently they need more business skills and knowledge.

Physician executives bring tremendous value to health care organizations by creating a bridge between clinicians and management and mediating areas of conflict. In order to realize the true value of this connection, health care organizations must allow their physician executives time to develop skills and managerial insights — and even underwrite the expense of education.

That doesn’t necessarily mean paying for an MBA. Most will find huge benefits from a continued education program that they can use to keep up with clinical skills and best practices, studying immediate issues like medical applications of artificial intelligence or the impact of social determinants on population health. ​Some programs like Emory University’s Chief Medical Officer program are specifically designed for experienced physicians and address core areas like the business and operational aspects of health care, diving deeper into topics like financial analysis, health care economics, and team culture building. These subjects are also discussed in the larger context of organizational transformation, as required with the massive changes in technologies like virtual care, telemedicine and AI becoming more prevalent. The remarkable thing about these programs, both that of Emory’s and others, is that they are accessible, affordable, and can work with the busy schedules of health care leaders.

Formal study gives physician executives the following advantages (among others):

Freedom to define their role. Physicians’ roles are relatively well-defined: A urologist in one health system can move to a different health system in another region, or even another country, and jump right in. In contrast, there’s no broad agreement on what a CMO does: It depends on the type and size of organization, the organization’s most pressing issues, and to some extent the CMO’s own priorities. A new CMO with no management training may struggle to balance conflicting expectations or move beyond how they’ve seen others do the job. Formal study can give them a clearer understanding of how they fit into the big picture and how to determine where their contributions can have the most impact.

Opportunities to network. Physicians are accustomed to consulting one another on difficult diagnoses or different treatment approaches. When they enter management, they need the same kind of consulting relationships but can’t automatically turn to internal colleagues or people they trained with. For CMOs, developing a new network that is oriented around management, strategy, and business issues can vastly increase their effectiveness and reveal new opportunities for them and their organizations. For instance, when the pandemic hit, every health system had to implement telehealth almost overnight. Imagine how helpful it would have been to be able to tap an existing network of other physician executives leading the same transformation.

Ability to ask the right questions. Though each organization is different — whether it’s a health system, an insurer, a government agency, a manufacturing company, or a medical communications outlet — they share one quality as far as their CMOs are concerned: They have priorities that aren’t covered in medical training. Corporate and organizational priorities are not always obvious. Particularly in the U.S., the complex and often contradictory imperatives and incentives of our health care system are enough to baffle even someone who aced medical school. Physician executives have to learn how to ask new types of questions and evaluate the answers in order to further the mission at hand. They also have to be prepared to hear answers they don’t like, and to develop strategies to deal with those unwelcome answers. We believe formal study is a better method than trial and error for mastering these new types of metrics and learning how to ask these new questions.

As physicians continue down the career path of a CMO, they must address the need for a new skill set. These skills might take longer to learn. However, with the right educational opportunities CMOs can feel better equipped to handle the most complex challenges faced by their organizations today. Physicians didn’t learn medicine solely on the job, and they shouldn’t have to learn business that way either.

John Whyte, M.D., is chief medical officer of WebMD. Ranil Herath is the president at Emeritus Healthcare.