Care Like a Doctor, Think Like a CEO

March 23, 2021

Do good doctors make good leaders? Physicians typically rise through the ranks of hospital systems based on their clinical acumen and outcomes, with many finding themselves in key leadership positions without requisite leadership or business training.

The University of Tennessee Medical Center (UTMC) and the University of Tennessee, Knoxville’s Haslam College of Business fill this gap with the Physician Leadership Academy (PLA), which teaches physicians to think like healthcare leaders and introduces them to skills including finance and lean management.

“We’re looking to empower physicians as agents of change,” Kate Atchley, executive director of the GEE Healthcare Division and director of the PEMBA program, says. “Our goal is for them to develop healthcare delivery solutions that maximize care quality and efficiency while maintaining affordability and increasing accessibility.”

The COVID-19 pandemic exposed the need for physician leaders to be responsive, innovative and collaborative. In healthcare’s turbulent new reality, most health systems cannot afford a long leadership learning curve.

Physician Leaders Can’t Fake It

Keith Gray (PEMBA, ’14), chief medical officer at UTMC, still remembers the first time he facilitated a medical executive committee meeting as the new chief of staff. Promoted after excelling in his cancer surgery practice, he was accustomed to leading teams and being the authority in the room. But on that day in the spring of 2012, as he moved through the agenda at the podium, things were different.

As the CFO presented his report, flipping quickly from spreadsheet to spreadsheet, Gray had a sickening feeling. He realized that he didn’t know what line the CFO was on, and that he couldn’t differentiate a balance sheet from an income statement.

“I prayed none of my medical staff colleagues would direct a question to me about the financials,” Gray says. “Then it hit me: I could no more fake it as a physician leader than I could as a cancer surgeon. Poor preparation in either area puts patient lives and communities at stake.”

After the meeting, Gray told his CEO about his vision of a leadership program that would teach physicians core administrative tenets, enabling them to excel in roles from the bedside to the boardroom and make effective liaisons between medical staff and hospital leadership.

With strong backing from senior administration, UTMC collaborated with Haslam to form the Physician Leadership Academy. They developed a program to provide physician leaders practical skills more affordably and conveniently than master’s level training. The didactics would be delivered on the UTMC campus during business hours.

UTMC wanted a program fitting its culture and its strategic initiatives and challenges. Faculty from Haslam’s graduate and executive education programs helped UTMC design a curriculum that not only covered core competencies such as finance, competitive strategy and process improvement, but also stressed the importance of leadership and communication styles that facilitate change.

What Success Looks Like

Participants complete 10 four-hour sessions and a two-hour Lean for Healthcare course over a calendar year, culminating with a physician leadership certificate and 42 AMA PRA Category 1 credits.

UTMC’s target was to train at least 10 percent of its medical staff. After graduating six PLA classes, 76 of the center’s 647 active medical staff completed the program, and nearly all UTMC physicians who moved into leadership roles since program inception graduated from the PLA. Several returned to teach components of the curriculum, while others, like Gray, completed an MBA. Forty-six alums currently occupy leadership roles on the campus, and 40 percent have been promoted to a higher leadership position since finishing the program.

The training fostered more standardized processes, improving coordination and communication of new programs and services, which transformed UTMC’s delivery system and increased value for employers, payors and patients. For example, PLA alumni run myriad UTMC disease-specific service lines that drastically simplify the care continuum. Physicians Lisa Duncan and James McLoughlin spearheaded the development of East Tennessee’s first biobank, which stores patient samples for future research that can improve the understanding of disease. Most recently, James Shamiyeh led the collaboration of several PLA graduates to successfully launch the region’s first ECMO (extracorporeal membrane oxygenation) program.

The training also has proved indispensable during the pandemic. “With only one exception, every physician member of the UTMC COVID-19 response team is a PLA graduate,” Joe Landsman, president and CEO, says. “These physicians have been key in helping our organization and our community navigate a crisis that has affected everyone. Also, they were active in formulating collaborative efforts with other area health systems that were recognized across the state and proved effective for the East Tennessee region.”

Future-Proofing the Healthcare Organization

UTMC plans to tailor the future PLA curriculum to address issues triggering major upheaval in the healthcare industry. Such issues include widespread burnout’s effect on physician satisfaction and retention, the roles of data analytics and telemedicine in delivering a value-based product and improving population health by addressing community health disparities.

PLA’s success has been emulated at UTMC and across the state. UTMC recently developed an Executive Leadership Academy for non-physician executive leaders, and Haslam worked with Methodist Le Bonheur in Memphis to implement a similar physician leadership program.

Gray believes that physician leaders are integral to making patient-centered changes in healthcare, but they need appropriate training to do so. “To get and keep people engaged, the training needs to be convenient, affordable and relevant,” he says. “That’s what made the PLA a pivotal investment for our organization.”