Harvard, Penn, Columbia Hire Doctors to Run Troubled Campuses

Recently, the president of Columbia University resigned after months of chaos, following in the footsteps of Harvard and my own school, Penn.

In addition to struggling with encampments, building takeovers, and graduation challenges, these three universities have something else in common: They all elected Ph.D.s to serve as presidents or interim presidents.

This may surprise some. But it doesn’t surprise me.

Over the past 15 years, I have trained over 2,000 physicians in leadership roles. I have seen firsthand how clinical decision-making and experience in the hospital trenches can prepare a physician to be an effective leader in medical and non-medical settings.

People who go into medical or nursing school are drawn to it because they naturally want to improve the lives of others. They must be exceptional students, mastering science, math, and literature. The combination of problem-solving skills and empathy for others is rarely required in other careers. Nevertheless, it is a key special ingredient that allows for success as a leader.

Many other medical skills are also essential to business. Medicine is one of the few professions in which clinicians are asked to lead organizations without much business training.

As patients, we like to think of our doctors as all-knowing scientists. Yet they routinely operate under conditions of considerable uncertainty, incomplete information, time pressures, and high stakes. They work in an improvisational theater where art and science, sensation and advanced technology, individualism and teamwork are holistically combined into outcomes that shape them as professionals and as human beings.

Most doctors don’t realize that business leadership is quite similar. Decisions often have to be made quickly, without all the facts. It may not have the same life or death consequences, but business leadership can have a definitive impact on financial and operational success, as well as employee performance, self-esteem, and desire to work for your company.

So experiencing imposter syndrome is not uncommon, and I’ve seen how cathartic it is for physicians to realize how transferable their skills are. They often value listening and learn to filter key priorities from the noise. They’ve been battle-tested in making critical decisions, working long hours in stressful environments, interacting with people from diverse backgrounds, and mentoring other physicians.

Physicians who rise to the top of universities have amassed a broad experience, of which being a physician is only one part. Katrina Armstrong at Columbia and Larry Jameson at Penn ran medical schools and large hospitals before they rose through the ranks. Alan Garber at Harvard inspired me to become a health economist. He pioneered the combination of a PhD in economics, becoming one of the first of his generation to defy specialization and combine seemingly unrelated fields. He also spent 12 years as vice provost at Harvard before taking the top job.

Physician leadership is becoming the norm. Physicians are everywhere. Congress has seen an increase in their numbers, with Rand Paul of Kentucky, John Barrasso of Wyoming, Roger Marshall of Kansas, and Bill Cassidy of Louisiana—all Republicans—in the Senate, and 15 physicians in the House of Representatives.

It’s important to understand that this phenomenon has both a push and a pull component. So far, we’ve discussed the pull: why clinical experience makes someone a better leader. But there are also push factors. Physicians, especially in primary care and family medicine, are finding that their work is increasingly driven by metrics that limit the time they can spend with patients. Job satisfaction is woeful, burnout is common and rising. As a result, both doctors and nurses are in short supply.

These trends are causing physicians to look around and realize that they can do more to pursue their passion for caring for and improving the health of populations by working for or even managing organizations such as health insurers, device manufacturers, pharmaceutical companies, and consulting firms.

A close friend—an anesthesiologist by training who also served as a hospital administrator—has decided to join a consulting firm where he is helping to transform healthcare delivery. He has stopped seeing patients and no longer wears a white coat. But he has a huge impact on patients, and he is happy, energetic, and productive.

The transition from patient care to organizational leadership presents physicians with a unique set of challenges. At the bedside, physicians are accustomed to having a direct, tangible impact on individual patients, which is an essential part of their professional identity. The transition to leadership, especially outside of the healthcare setting, requires them to broaden their perspective, focus on diverse stakeholders, operational efficiency, and strategic vision. This transition often requires developing new skills in management, finance, and communication, areas that are not typically emphasized in medical training.

Moreover, physicians may struggle with the loss of the direct patient interaction that originally drew them to the field, potentially leading to identity conflict. Their reputation and credibility among peers, long built on clinical excellence, must now be reestablished in the realm of leadership, where success is measured by a variety of metrics. Balancing these new responsibilities while maintaining a medical ethos can be daunting, but it is essential for those who wish to effectively lead organizations.

Physician leadership programs like the one I lead at Wharton often emphasize the comparative advantage that clinical training can bring to leadership, as opposed to a reset from being a doctor to being a CEO. The goal is to leverage years of rigorous study and experience into leadership informed by knowledge, compassion, and vision. To accomplish this, our program at Wharton focuses on developing key skills in three areas: leadership tools and knowledge, business acumen, and the necessary context required to navigate a rapidly changing environment.

The clinician is not for everyone. And as a society, we need to do a better job of making the work of clinicians more manageable, rewarding, safe, and fulfilling. But those looking for leaders for ailing organizations, even outside of medicine, may find that the clinician is simply what the clinician ordered.

Guy David, Ph.D., is the Alan B. Miller Professor of Health Care Administration at the Wharton School, a professor of health policy at the Perelman School of Medicine, and a senior research fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.