I was very anxious to hear the results of the election. I was nearing the end of my second year of family medicine residency. I had adjusted to the stress of changing clinical rotations every 4 to 8 weeks. I was starting to feel more confident with the clinical material.

election hospital executive

But I was drawn to leadership opportunities. At our program, the chief resident was elected by the other residents. I “ran” for the position against one of my good friends in a low-key, respectful race.

I was very pleased when the residency director announced that I had been elected to the position!

I enjoyed attending the meetings with residency leadership, contributing the residents’ perspective to important conversations. I took on additional work planning events. I updated manuals and created a more comprehensive list of elective rotations available to the residents.

I had no inkling that these pursuits would be repeated later in my career. At the end of my residency, my only concern was to find a good position with a small independent family medicine group. I wanted to continue to hone my medical skills and practice family medicine, including obstetrics. I did not give any thought to being involved with management or leadership.

Eight years later, I started a process that would lead me to a full-time non-clinical position as a hospital executive. Physicians are being drawn to non-clinical careers for a variety of reasons. Some are disenchanted by long hours, declining insurance payments, greater paperwork burden, and burnout. Others find that clinical medicine is not as exciting or fulfilling as expected and are interested in work that is more entrepreneurial, innovative, flexible or challenging.

burnout hospital executive

This has resulted in an explosion of physicians seeking part-time or full-time non-clinical careers. And it is not always easy to decide which potential job will be the most rewarding.

I’d like to describe why I chose a career as a hospital executive, and the pros and cons you may want to consider as you explore new career options.

Five Factors for the Potential Hospital Executive to Consider

I briefly contemplated moving into several non-clinical areas. One of my colleagues was doing chart reviews for an insurance company. Another had begun doing surveys for the Joint Commission. Consulting seemed to be exciting, but I worried about all of the travel that might be required. And I had read about other jobs like medical writing or working as an expert witness.

All of these options are legitimate, respectable jobs.  I listed other options in a previous post (Options for a Non-Clinical Career).

But there are several factors that drew me to a career as a hospital physician executive.

Leverage and Impact

I enjoy providing medical care to patients, addressing their fears and concerns, watching them respond to treatment and sensing their gratitude. But it often seemed so incremental. And with some patients, care was almost trivial – treating the common cold, minor injuries, insignificant infections, and the worried well.

crowd hospital executive

I became very interested in helping groups of patients with illnesses where reductions in mortality or complications could be achieved. Working as a hospital executive provides that kind of impact because of leverage.

The leverage involves leading teams, engaging staff and physicians, developing protocols and implementing best practices. Effectively leading and managing can produce big improvements in outcomes.

Quality of Life

Physician executives are busy. But, we generally have better control of our schedule. Vacations can be taken without the need to find coverage for patients.

vacation hospital executive

Staffing is handled by the HR department. The stress of malpractice is gone. Continuous learning is necessary, just as in clinical medicine, but it is easier to find time to attend educational conferences.


This career as a hospital executive has a good chance to maintain or improve income, especially for primary care physicians. As an experienced and valued vice president or chief medical officer, it should not be difficult to achieve salary and benefit levels that easily exceed the income of the average family physician, pediatrician or psychiatrist. The same may not be true for a busy cardiologist or surgeon.

hospital executive dollars


Once in an administrative position, there is still opportunity to grow.  New challenges occur daily and opportunities often arise, moving into the chief operating officer (COO) position, for example. Also, many of us make a lateral move to the same position, but in a larger hospital or health system.

And there are more opportunities for the physician executive to fill the CEO role as well. Such opportunities for growth don't often arise in many of the other non-clinical jobs.

climber hospital executive

Some of us shift into a different type of healthcare organization, like a large medical group or an insurance company. This is not something the chart reviewer or writer has as an option.


My research indicated to me that there was a new trend in hiring physician executives when I initially began my transition. I was the first VPMA and CMO at my hospital.The number of hospital CEOs continues to grow.

wanted hospital executive

It seemed a fairly safe choice to make when I started, and it continues to be an area of growth and continuing demand.

Final Decision

A decision to move into one of these areas is not set in stone. Try different activities. See what you really enjoy doing. But if you're like me, and are looking for a career that offers an ability to impact patients, improve your quality of life, enjoy financial stability job security, and growth, a career as a physician executive is worth considering.

What are the other factors should be considered?