From Bedside to the C-Suite: A National Survey on the Evolving Role of Physician Leaders in U.S. Hospitals

Physician leadership roles now demand competencies beyond clinical expertise. Although skills and training models have been described, not much is known about the development pathways and operational challenges faced by current physician leaders. The Healthcare Physician Leadership Survey was conducted in late 2024 and early 2025 to assess essential skills, developmental pathways, and the challenges that physician leaders face. The 23-item survey, administered via REDCap, was distributed through emails, social media platforms, and newsletters from relevant professional organizations. Responses were received from 254 physician leaders, most of whom (70%) were affiliated with hospitals or health systems. Physicians rated as important (a four or five on a five-point Likert scale) these leadership skills for success: emotional intelligence (94.7%) and communication skills (93.5%) ranked highest, followed by team building/collaboration (88.8%), strategic thinking (88.4%), and time management (83.2%). Leadership skills were primarily acquired through on-the-job experience, with mentorship and peer networks as key supports. Access to formal training was inconsistent as men were more likely than women to hold a graduate degree (53.8% vs. 36.6%; P=0.03) and to receive full organizational funding for any formal training, including certifications (38.3% vs. 24.24%; P=0.003). The most common challenges physicians faced were balancing clinical and leadership responsibilities (51.6%), more so among women (61%) than men (45%), followed by staffing shortages (39.0%), budget constraints (38.6%), and interdepartmental communication issues (27.2%). Organizations can strengthen physician leadership by providing protected time for administrative duties, ensuring equitable access to skill-building/career development training, addressing operational barriers, and incorporating leadership skills into hiring and professional development.