“I thought that took a fair amount of courage,” she says, “on Day 3, to stand up to the mic and have [a] specific conversation with the president of the company. In my mind, he was very enlightened. His comments were very enlightened.”
Firm Foundation
Robert Zipper, MD, MMM, SFHM, chair of SHM’s Leadership Committee, and CMO of Sound Physicians’ West Region, says it’s probably not realistic for a hospitalist to vault up immediately to a chief executive officer position. Pursuing lower-level leadership roles would be a good starting point for hospitalists with C-suite aspirations, he says.
“For those just starting out, I would recommend that they seek out opportunities to lead or be a part of managing change in their hospitals. The right opportunities should feel like a bit of a stretch, but not overwhelming. This might be work in quality, medical staff leadership, etc.,” Dr. Zipper says.
For hospitalists with leadership experience, CMO and vice president of medical affairs have the closest translation, he adds. He also says jobs like chief informatics officer and roles in quality improvement are highly suitable for hospitalists.
According to the 2011 Cejka Executive Search Physician Executive Compensation Survey, a survey of the American College of Physician Executives’ membership of physicians in management, the median salary of physicians in CEO positions was $393,152. That figure was $343,334 for CMO and $307,500 for chief quality and patient safety officer. The median for all physician executive positions was $305,000. Compensation was typically higher in academic medical centers and lower for hospitals and multi-specialty groups.
Hospitalists in executive positions had a 2011 median income of $275,000, according to the survey.
The survey also showed a wide range of compensation, typically dependent on the size of the institution. Some hospitalist leaders with more than 75% of their full-time-equivalent hours worked clinically “might actually take a small pay cut to make a move,” Dr. Zipper says.
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Median physician executive compensation, by position
Natural Progression
The hospitalist executives interviewed, for the most part, were emphatic that C-suite level leadership was not something that they imagined for themselves when they began their medical careers.
“In 2007, I could never imagine doing anything less than 100 percent clinical hospitalist work,” UCLA Hospitals’ Dr. Afsar says. “But once I started working and doing my hospitalist job day in and day out, I realized that there were many aspects of our care where I knew we could do better.”
Dr. Harte, president of South Pointe Hospital in Cleveland, says he never really thought about hospital administration as a career ambition. But, “opportunities presented themselves.”
Dr. Torcson says he was so firmly disinterested in administrative positions that when he was asked to join the Medical Executive Committee at his hospital, his first thought was “no way … I’m a doctor, not an administrator.” But after talking to some senior colleagues about it, they reminded him that he was basically obliged to say “yes.” And it ended up being a crucial component in his ascent through the ranks.
Dr. Narang imagined having a career that impacted value fairly early on, after making observations during his pediatric residency. But even he was surprised when he got the call to be CEO, after less than two years on the job.
Now, in retrospect, they all see their years working as a rank-and-file hospitalist as formative.
As a leader in a hospital, you have to be good at recruiting physicians, retaining them and developing them professionally, Dr. Harte says. That requires having clinical credibility, being a decent mentor, being a good role model, and “wearing your integrity on your sleeve.”