As consolidation rises throughout healthcare and physician shortages persist, physician leadership has been on the decline.
Five physicians recently joined Becker's to discuss the factors holding physicians back from leadership roles.
Editor's note: Responses have been lightly edited for clarity and length:
Amarinthia (Amy) Curtis, MD. Medical Director of Gibbs Cancer Center & Research Institute (Spartanburg, S.C.): The biggest barrier to physicians stepping into leadership roles in 2025 is the sheer demand for their clinical expertise. Every hour a physician spends away from patient care is difficult to replace, making it essential for both physicians and healthcare systems to be intentional about the purpose and structure of physician leadership.
Physicians are natural leaders — driven by a deep commitment to both individual patients and the broader healthcare system. To transition into leadership, they need confidence that their expertise will drive meaningful change. This requires clarity on accountability, the scope of responsibilities — whether launching a new service line or overseeing an existing one — and the level of institutional support provided. Effective physician leadership is not just about taking on a title but about ensuring the right structure is in place to maximize their impact.
Seref Bornovali, MD. Hospitalist and Post-Acute Medical Director of Velocity Clinical Research (Cincinnati): No. 1, general issues not specific to 2025: Many physicians, no matter how competent they are, are not very comfortable about leadership in general. Caring for patients [and] helping people are very satisfactory duties that do not leave room for much else. Another reason is the inherent confrontational nature of leadership. Having "difficult conversations" with colleagues and coworkers is simply not for everyone.
No. 2, about the current situation: Until recently, healthcare leadership used to be seen as one of the very few leadership categories with job security. As an example, a chief medical officer only left their position for retirement or taking a new job. Recently, we started hearing about medical leaders who had their positions "eliminated" or "consolidated." This certainly does not help attracting new candidates to the open roles. Not too many people would want to be put in a position to explain a short stint in leadership on their CV. We also have to add all this to current political uncertainty regarding availability of federal funding for healthcare and academics. I believe it is understandable that a physician wants to stay put in a more secure clinical practice position instead of walking in a very uncertain and insecure environment.
Marc Shelton, MD. Associate Professor of Cardiology at the University of Missouri Health System (St. Louis): Physician leadership in healthcare has never been more critical, yet fewer physicians are eager to step into these roles. While many discussions focus on traditional barriers such as time constraints and administrative burdens, there are additional reasons why physicians are increasingly disenchanted with leadership positions. Here are some factors that may not always be at the forefront of the conversation:
No. 1: Dwindling financial support for leadership development. Many healthcare systems once supported leadership training and MBA programs for physicians, but funding for these initiatives has significantly declined. Without financial backing, physicians must choose between personal financial investment or forgoing formal leadership education altogether.
No. 2: Disillusionment from [reductions in force]s and downsizing. Having lived through rounds of RIFs and downsizing, many physicians have witnessed firsthand the tough decisions leaders must make. The emotional toll of seeing colleagues laid off and departments restructured makes the idea of stepping into leadership less appealing.
No. 3: High turnover among physician mentors. Many experienced physician leaders have moved on or transitioned into different roles, creating instability in leadership pipelines. High turnover rates in physician leadership positions further discourage younger physicians from pursuing these roles.
No. 4: Compensation disparities. The financial model for physician leadership often fails to compete with what physicians can earn in full-time clinical practice. Given the increasing demand for clinical services, many physicians find it more financially rewarding to continue patient care rather than transition into administrative roles with lower compensation.
No. 5: Inconsistent valuation of physician leadership. While some healthcare systems genuinely value physician leadership, others may only claim to support it without backing it up through action. Physicians who step into leadership roles may find themselves lacking the authority or resources to drive real change, leading to frustration and disillusionment
No. 6: Focus on cost-cutting over growth. While healthcare organizations frequently emphasize growth in their strategic plans, physicians often observe a disproportionate focus on cost-cutting. True growth requires capital investment, but with current fiscal challenges, many systems allocate more energy toward reducing expenses rather than expanding services in meaningful ways.
No. 7: The reality of staffing challenges. Physicians understand that sustained improvement and growth require additional staffing. However, given ongoing workforce shortages and financial constraints, they see firsthand how difficult it is to secure the necessary personnel to support new initiatives. This realization makes leadership roles appear more burdensome than rewarding.
Jared Corn, MD. Radiologist at Radia (Killeen Temple, Texas): This is easy for me. I would lose money if I went into leadership. I feel like this is why I tend to see more low paying specialties going into leadership compared to higher paying specialties.
James Knavel, MD. Orthopedic surgeon (Lake Geneva, Wis.): The majority of physicians no longer own their practice. They are employees of much larger organizations and, rightfully, feel that they will have very little influence over the entities whose primary goal is to maximize shareholders profit. They are under great pressures to increase procedures done and minimize length of office visits to increase revenues. Many of the younger doctors have overwhelming debt from loans. Instead of simple office notes, they have to comply with demands of EHR. Is it any wonder that they do not see any benefit to them of trying to get involved in leadership positions that they know will not benefit them in any way?