Responding to the Challenge of Developing Physician Leadership

Tuesday, November 14, 2017

What are some of the best tactics for developing physicians as leaders?

Cone Health was keen to discover the answer to this question. The Greensboro, North Carolina–based health system wanted to shift in a bold direction toward attaining top outcomes in quality, patient satisfaction, employee and physician satisfaction, and critical financial metrics. To transform, executives of this nonprofit, integrated network of more than 11,000 employees recognized that they had to enhance the relationship between their 1,300 physicians and system administrators.

According to Press Ganey, a leading consultant to health systems seeking improvement in patient outcomes and other performance measures, the satisfaction scores of the organization’s physician population can be a leading indicator of progress toward that goal. The firm states that “Organizations that meaningfully engage and collaborate with physicians are on the path to providing better care as strong physician engagement can create better patient experiences and improve the quality of care.” To encourage progress in this area, Cone Health partnered with the Center for Creative Leadership (CCL) to create the Physician Leadership Academy (PLA)—an initiative designed to build collaborative relationships, enhance leadership skills, and ensure that physicians are engaged and aligned with efforts to improve performance.

The 12-month, multisession leadership development initiative began in 2012. It includes coursework, action learning team projects, and individualized executive coaching support. While physicians identified have demonstrated high levels of clinical expertise and leadership capability, Cone was interested in developing the physicians’ organizational perspective and strategic vision.


Access to quality, affordable healthcare remains at the center of U.S. political and kitchen table debate. Cone Health wanted to help physicians understand their role as system leaders at a time in which they are beleaguered by constant change. The organization also wanted to develop a physician population empowered to influence their own professional destinies, as well as the improvement of wellness and healthcare delivery metrics within Cone.

To maximize the learner experience, Cone’s CEO, chief clinical officer, and executive vice president of innovation and transformation were instrumental in ensuring that physician leaders were visible and supported by executives. The organization’s multiyear investment in the PLA exemplifies a commitment to growing a cadre of physician leaders capable of working collaboratively to address the organization’s most complex challenges.

Central to the development process was introduction of CCL’s leadership framework: Direction-Alignment-Commitment (DAC). The Center for Creative Leadership defines direction as “widespread agreement in the group on overall goals,” alignment as “coordinated work within the group,” and commitment as “mutual responsibility for the group.” A high degree of trust and motivation for the group’s outcomes are also necessary. Using DAC as a framework throughout, physicians better understood leadership as a social process with contributing factors beyond their significant personal achievements and capabilities.

While viewing leadership as a collective process does not come naturally to many highly accomplished physicians, CCL’s goal was to develop within Cone physician leaders the ability to recognize—both in their own teams and the larger organization—when leadership was happening (or not) and to develop the capacity to influence the leadership process toward more positive results. Participants used the DAC assessment as a tool for analyzing their experience of existing leadership processes. The diagnosis helped physicians determine where better outcomes could be achieved.

Across cohorts, both physicians graduating from the PLA and their observers have reported improvement in the following key areas:

  • networking and relationships
  • strategic thinking
  • collaboration
  • confidence in leadership
  • boundary spanning
  • self-awareness
  • being a better team player.

Over four cohorts surveyed, 91 percent of physicians on average reported an increase in personal development, and 89 percent reported increased organizational impact in the areas for which they are responsible.
Cone executives’ investment in development, and their commitment to the success of the PLA, continues to influence how physician leaders communicate, collaborate, and innovate within the system. The initiative represents an excellent example of how providing a common leadership language and the safe space for practicing new skills enables physicians to address blind spots and celebrate successes as they work toward a shared vision.

About the Author
Deborah Torain is a strategic business partner with the Center for Creative Leadership. Based in Greensboro, North Carolina, Deborah works to build and manage relationships with a wide variety of CCL clients, leading to the design, development, and delivery of customized CCL solutions. Deborah has led CCL’s business development efforts within the healthcare sector, working with nonprofit, faith,- and community-based health networks, academic medical centers, for-profit systems, public health entities, and the Veterans Health Administration. Deborah holds a BA in communications and public relations and a master of higher education administration, both from the University of North Carolina at Greensboro. She is currently pursuing a doctorate in leadership studies at North Carolina A&T State University with a research focus on physician leader development. She can be contacted at
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