An impressive title in healthcare isn’t the flex you think it is.
Physician leaders, don’t get so comfortable as a Medical Director, VPMA or Chief Medical Officer that you assume you’ve separated yourself from the pack. You may be leading a cost center, a non-autonomous entity or an execution-only organization without true business-unit sovereignty. In that case you may hold a significant title and still lack a differentiator.
Scope of accountability, not title
A title doesn’t separate you from the pack. Scope of accountability does.
The real question is: what do you actually own? Are you helping build something that fundamentally changes how healthcare is delivered, what it costs and the outcomes it produces? That is extraordinarily difficult without the authority to make decisions, control resources, allocate capital and drive execution.
The three things to own
If you want to establish yourself as a true healthcare business leader, progressively take ownership of three things:
- People: How many FTEs actually report to you?
- Budget: Do you have meaningful authority over resources and spending?
- P&L: Do you have direct profit-and-loss accountability?
The last one represents the highest level of operating accountability.
Influencing the business vs. owning it
This doesn’t mean dyad or triad leadership models don’t work. They absolutely can. But there is a fundamental difference between influencing the business and actually owning it, and that difference matters.
The healthcare leadership landscape has shifted. Clinical expertise, physician credibility, governance and community relationships remain enormously valuable. For physician executives, particularly outside academic medicine, those capabilities alone may not establish you as an enterprise operator.
Clinical quality is the baseline. Operational leadership, financial stewardship and resource allocation are the differentiators. Ultimately, accountability for results is the differentiator.
Look beyond the “Chief” in your title
You report directly to the CEO. You sit in the C-suite. You carry a title that sounds equivalent to your peers. Yet the underlying structure may tell a different story:
- The title gap: Your fellow C-suite executives are EVPs, while you remain an SVP or VP.
- The payroll divide: They sit on the corporate or division payroll with executive-level benefits, while you remain tied to a local facility payroll.
- The resource question: You have the seat but lack the independent budget or dedicated resources to execute enterprise-wide mandates.
None of these details tells the full story in every healthcare system. Taken together, they raise important questions about organizational design, authority, accountability and how physician leadership is positioned within the enterprise.
Being invited to the table is one thing. Having the structural authority, resources and enterprise standing to influence what happens at that table is another.
Move beyond the title
You don’t get to assume credibility. You have to build it. If you want to be taken seriously as a healthcare business leader, stop just talking about the business.
Own the people. Own the budget. Own the P&L. Own the outcome.
That’s where leadership gets real.
Disclaimer: These are my own views, shaped by my experience in healthcare — not the position of any employer, client, or organization I’m affiliated with.