Trading a white coat for the business suit of an executive offers its share of rewards but requires hard work and added responsibility, say otolaryngologists who have transitioned from clinical practice or academia to the boardroom.
The job of a physician executive comes with added responsibilities, such as reporting to governing boards and reviewing the performance of fellow doctors. Otolaryngologists who have not been exposed to these areas may want to consider them before pursuing an executive track, said Barbara Linney, recently retired as vice-president of career development for the American College of Physician Executives (ACPE), an organization that offers training and career services to physician executives.
For otolaryngologists who relish collaborating with other leaders in the field, multi-tasking and making big-picture decisions for their organizations, a career as a physician executive can be challenging and rewarding.
A Nonprofit Career
Early military training and a love of politics steered Michael D. Maves, MD, to a career in executive leadership. Dr. Maves is currently executive vice president of Project HOPE (Health Opportunities for People Everywhere), a 54-year-old non-governmental organization that focuses on fighting infectious and noncommunicable diseases and seeks to improve the health of women and children worldwide. The Virginia-based organization conducts approximately 100 programs in 35 countries, operates with a $225 million budget and employs nearly 400 people worldwide. Currently, Dr. Maves’ duties include overseeing program management, marketing and business development.
Looking back over his career, Dr. Maves said he first realized he had leadership abilities as a young man serving in the U.S. Army, when he was charged with persuading people to work together for a common goal. He ran a troop medical clinic in what was then West Germany and was responsible for setting up the clinic and emergency room, along with ambulance, laboratory and X-ray services. The military gives you responsibility well beyond your years or experience, said Dr. Maves. “As things kind of developed, [this] was probably the first time I really knew that I could motivate, lead and direct people.”
Dr. Maves earned his medical degree from and completed his residency at Ohio State University. His dual interests in politics and the business of medicine led him to pursue an MBA. Later, as professor and chair of the department of otolaryngology at the St. Louis University College of Medicine in Missouri, Dr. Maves put his MBA to use and began participating in politics. His political activity intensified when he was tapped to represent otolaryngology as a specialty on the political front after health care issues took a more prominent political stage in the 1990s. “[This] was a big shift for me at that time, because I really stopped doing active clinical medicine on an everyday basis,” said Dr. Maves, who never expected his political engagement to last more than a few years.
Prior to his work with Project HOPE, he served as executive vice president of the American Academy of Otolaryngology-Head and Neck Surgery and CEO of the American Medical Association (AMA), a job he left in 2011 after a decade of service. “[The AMA is] a large-scale operation where you have to employ all of the tools that you learn in business school,” said Dr. Maves. At the AMA, Dr. Maves communicated the needs and concerns of 220,000 physician members to policy makers on Capitol Hill. “For much of the time I was at the academy and at the AMA, I used to tell people that a big part of my job was being a translator,” said Dr. Maves. In other words, he translated the language of business and politics for physicians and otolaryngologists, while also taking the concerns of doctors and putting them into language politicians would understand.
In a business environment, be prepared for critics, he said. One way to prepare for the inevitable politics of an executive post is to watch the television show “Survivor,” where people get voted off the island week after week, he added. “You need to get a much tougher skin than we have as physicians.”
Look Beyond the Individual
Robert Miller, MD, currently the executive director of the American Board of Otolaryngology, said the role of an executive demands dedication to the overall organization or company, which often means a big shift in priorities and a focus on common goals.
“I think it’s important that you get along with people and that you are willing to put the organization’s goals and missions above your own personal goals,” he added. “When you’re practicing medicine, your responsibility is to that patient in front of you, [to] do the best you can for that patient. As an executive, your responsibility is to do what’s best for the organization.” Doctors tend to look at issues from a medical perspective, while business people look with an eye to policy, finances and efficiency, he said.
Dr. Miller served as the otolaryngology department chair at Tulane University in New Orleans, where he discovered an affinity for administration that led him to pursue his MBA and ultimately become vice-chancellor of the medical center. “I found myself more and more attracted to administrative positions,” he said. He gave up clinical practice for the role of an executive in 1999 and said he misses the patient interaction and teaching more than he does the surgery. “As a cancer surgeon, you really do get to know patients and have an impact on their lives and their families’ lives,” he said.
Dr. Miller advises otolaryngologists considering the physician executive route to get involved with a local hospital, try out leadership roles and possibly take a business course. But, he said, becoming an executive might not be the right path for everyone. “The stresses are somewhat different—dealing with employees, dealing with issues beyond just the patient in front of you. Every job has its stresses; they’re just different. Maybe that’s part of how you decide what it is you want to do: What kind of stress do you like?”
Running a large organization as a physician executive requires hard work and determination, but it’s also great fun, said Michael M.E. Johns, MD, who has served as chancellor at Atlanta’s Emory University and as executive vice president for health affairs and head of the university’s Robert W. Woodruff Health Sciences Center.
“If you can move an organization forward and make it successful or keep it being successful, there’s a lot of satisfaction to it,” said Dr. Johns. “It’s a lot of hard work…[and you had] better enjoy solving problems,” because that’s what a good portion of the job of a physician executive entails, he added.
Dr. Johns earned his medical degree from the University of Michigan Medical School, where he also completed his residency. Before his stint at Emory, he held the position of dean of the Johns Hopkins School of Medicine and vice president of the medical faculty at Johns Hopkins University. The opportunity to serve as dean arose from Dr. Johns’ earlier work at the university but was not a specific goal he set out to achieve, he said. And when it arrived, it was not so much a profound moment as it was an obvious choice of “why not?” he recalled. “Nobody just makes a crack decision and says I think I’ll leave medicine and become the dean at the Johns Hopkins School of Medicine. These are evolutionary events,” he said. “I moved into the vice dean job, and the opportunity to be dean looked interesting and challenging, and of course it’s a distinct honor as well. So, I said, ‘I’ll do it.’”
People don’t become leaders by just raising a hand and proclaiming the desire, he said. The top person helps and guides employees and holds everyone accountable to the organization. “You better have a vision for where you want to go. You’ve got to have a plan that gets you there. You have fiduciary responsibility for the organization, and you’ve got to inspire people.
“You have to be able to attract great people around you, submerge your own ego…so those around you can rise and be successful. And enjoy yourself and have fun while you’re doing it.”
Transitioning to an Executive Career
Doctors contemplating a career switch to executive management often seek counsel from Linney or others at the ACPE. They come from various backgrounds and specialties and have usually already volunteered for management duties and discovered they enjoy it, said Linney.
Recruiters have told Linney recently of fierce competition for physician executive job openings. Annual salaries for doctors in executive roles range from $250,000 for entry-level positions to $350,000 and higher for some CEO posts, she said. That’s typically an increase from a traditional clinical practice setting, unless the doctor is a surgeon or in a high-paying specialty.
One reason physicians are hired for executive roles is that, from a management perspective, they can stand their ground with other physicians, said Linney, who has taught an ACPE course on managing physicians. “Anybody else can talk to a doctor, and the doctor can say, ‘You don’t understand. You do not know about patient care. You do not know what I’m dealing with here,’ she said. “Physician to physician, that cannot be said.”
The demanding job of an executive includes financial responsibility and accountability over much larger budgets than are typical in a medical practice. The ACPE offers courses for doctors-turned-executives on financial business applications, as well as graduate programs at various campuses across the U.S.
While the waves can get rocky for executive leaders, the position has its share of rewards as well, said the physicians interviewed. One of the most gratifying is the chance to have a greater impact on many patients’ lives. In management positions, your contribution often has a broader reach, said Dr. Miller.
“When you’re dealing with a patient face to face or in the operating room, you’re dealing with one patient, one person,” he added. “[With] administrative issues, you may be dealing with many patients, making decisions that affect many patients and, hopefully, improve a larger number of lives.”
Adapted with permission from the American College of Rheumatology