What does physician leadership look like around the world? What motivates physicians to step into leadership positions? What challenges do they face? What are their greatest triumphs? We asked several American Association for Physician Leadership (AAPL) international members about their experiences and insights into healthcare and physician leadership. Physician leaders in Qatar, Canada, the Bahamas, Japan, St. Kitts & Nevis, Australia, and India share their stories here.
Bridging East to West as a Physician Leader
Patricia A. Abboud, MD, MBA, CPE, RN
“My little doctor.” These are the words I remember my mother saying to me in Arabic during my elementary school years in Cleveland, Ohio. Fast forward 40 years, and I am now a pediatric intensivist and PICU medical director in Qatar.
My path to medicine and eventual move to Qatar has been unconventional, yet not entirely unique. I began my career in healthcare as a registered nurse before deciding to attend medical school. After completing my pediatric residency at Dayton Children’s and critical care training at Cincinnati Children’s Hospital Medical Center in Ohio, I spent 12 years working in the United States, taking on various clinical and leadership roles, such as medical director, committee lead, and chair of medicine, which sparked my interest in the administrative side of healthcare.
I was recruited to join Sidra Medicine, a newly established tertiary research hospital in Qatar, which opened in January 2018. At that stage in my career, I was eager for more challenging leadership roles and the chance to be part of a new institution that combined Western healthcare practices with a familiar work environment. As a native Arabic speaker married to an engineer born in Lebanon, and with an adventurous spirit, I viewed the move as an exciting opportunity for our family.
Upon joining Sidra, I quickly assumed various roles to prepare the hospital for its grand opening, developing policies, procedures, workflows, and processes. During our first year, we sought Joint Commission International Accreditation, and I was chosen to lead one of the clinical chapters, thanks to my background in the U.S. healthcare system. My expertise in transport medicine led me to develop our program, and within two years, I became the division’s medical director.
Over the past seven years abroad, I have remained active in many U.S. professional organizations, including the AAPL, which has greatly benefited my career. My passion for leadership and administration prompted me to pursue my CPE through the AAPL, and I recently earned my MBA from the Isenberg School of Management at the University of Massachusetts Amherst.
I do not feel limited in any way as a woman in a leadership position here in Doha; a strong work ethic and proven results are key to achieving success, regardless of gender. This journey has been both exciting and rewarding. Having been part of Sidra Medicine since its inception, I am poised to continue contributing to its growth and helping it remain a beacon of healthcare excellence in the region.
Physician Leadership in the Bahamas
Sheena Antonio-Collie, MD, MMM, CPE
The Bahamas has two distinctly different health systems; I work in the private healthcare space. Doctors Hospital Health System is a private institution and is the seat of most healthcare technology and innovation in the country. Leaders in healthcare for more than 50 years, we most recently became the leaders in physician leadership.
Charles Diggiss introduced the clinical directors program to DHHS in 2001. I was appointed clinical director for infection control and the medical/surgical unit. In this role, I was the lead physician in collaborating with other stakeholders, such as the nurses, to develop policies, monitor practices, and develop educational programs.
My team and I worked on basic patient care initiatives that had an emphasis on patient safety — most notably, the introduction of universal screening for MRSA in 2008. As a result, we now have near-zero rates of hospital-associated MRSA infections. The clinical directors played an integral part in the hospital’s success at The Joint Commission International Accreditation inaugural exercise in 2010.
Dr. Diggiss introduced the clinical leaders to the American College of Physician Executives. I began diving into the offerings of this organization immediately. These experiences illuminated a new direction for the path I would take in my journey. Physician leadership became my North Star.
My appointment to vice president of medical affairs in 2016 introduced me to the executive committee, where words like “metrics” and “agility” came alive. This space was initially lonely, as I was the only physician other than the CMO. Although I was a little bit of an oddity to the other members of the team, I was determined to learn the culture quickly. I became the vital “clinical voice” for my corporate colleagues, leading to successful dyad/triad relationships.
In January 2020, I was appointed chief medical officer. The Bahamas diagnosed the first COVID-19 patient three months later. Diving into the deep, armed with my new Certified Physician Executive designation and the help of a team of professionals, both clinical and nonclinical, helped us navigate a tumultuous period. Paradoxically, this launched the health system into an accelerated phase of growth.
During my formative years in physician leadership, there was a paucity of mentors. One of my ultimate goals is to create that illumination for other physicians who will walk or even stumble into this very exciting aspect of healthcare.
From the Bedside to the Boardroom, Eh? Physician Leaders Steering Canada’s Healthcare Transformation
Khalid Azzam, MBBS, MS-HQSMi, FACP, FRCPC, CPE
As a physician leader in the Canadian healthcare system, my journey has been shaped by the complexities and opportunities of working in community-based, academic, and regional hospitals in a publicly funded system.
In my current role as the physician-in-chief at Hamilton Health Sciences (HHS), a large multisite academic healthcare system, I oversee more than 500 credentialed physicians, most of whom are also faculty at McMaster University, where I hold a position as a professor of medicine, contributing to both clinical and educational scholarship. This leadership role places me at the vital intersection of clinical care, academic medicine, and healthcare innovation.
A hallmark of the Canadian healthcare system is its publicly funded nature, which offers significant strengths and challenges. On one hand, it ensures universal access to care, providing essential healthcare services to all Canadians regardless of socio-economic status. However, it is also constrained by limited resources and systemic issues such as shortages in health human resources, limited inpatient beds, long wait times, backlogs in services, and restricted access to long-term care and community services.
These constraints negatively affect patient outcomes and perpetuate a cycle of increased admissions and extended hospital stays.
Compounding these challenges is the growing number of Canadians facing mental health and addiction issues, including children, which was exacerbated by the COVID-19 pandemic, yet access to treatment remains limited.
Leadership within Canadian hospitals provides an opportunity to directly affect patient outcomes at the frontlines. In Canada in recent years, quality improvement has become a key focus in addressing the ongoing challenges in our healthcare system. There is a concerted effort to provide safe, timely, effective, efficient, equitable, and patient-centered care, with a growing interest in data-driven approaches to achieve these goals.
Health equity has also taken center stage, especially following the pandemic. HHS initiated a project called CARE (Collecting Accurate and Robust Equity) data aimed at gathering patient demographic information to better understand and address disparities in healthcare delivery.
This aligns with our broader commitment to advancing equity, diversity, and inclusion. Additionally, my work with a team of like-minded leaders at HHS and McMaster University has focused on developing Equity-Driven Diagnostic Excellence competencies for healthcare professionals, which is now in the manuscript-writing phase.
In the face of mounting pressures on our healthcare system — driven by increasing demands and diminishing resources — innovation is essential. New approaches such as virtual care, post-discharge remote monitoring, hospital-at-home models, artificial intelligence, optimizing the scope of practice, and creating new care pathways have emerged as vital tools for improving care access and patient outcomes. Physician leaders in hospitals and academic settings are pivotal in driving these innovations forward.
At HHS, we have taken bold steps to address the health human resource crisis by integrating physician assistants and expanding hospitalist programs, positioning ourselves as a local, provincial, and national leader.
During the past two years, in collaboration with operational and academic leaders, we have transformed the internal medicine service at one of our academic tertiary hospitals from a resident-dependent model to one entirely run by internal medicine physicians acting as hospitalists — marking a first in Canada.
The success of this transformation has not only improved patient flow and reduced length of stay but also positively affected resident education at other sites and created the infrastructure to train academic hospitalists, illustrating the powerful role physician leadership can play in enhancing patient outcomes, hospital efficiency, and system sustainability.
The future success of our healthcare system depends on bridging the gap among primary care, hospital care, and care in the community. Physician leaders must foster collaboration across these domains, embracing technology-driven, patient-centered, and sustainable solutions to address the key challenges in Canadian healthcare.
By pushing for innovation, maximizing scopes of practice, and championing quality-focused care, we can create a truly efficient, effective, and equitable healthcare system for all Canadians.
Leadership in the Australian Healthcare Sector
Andrew S. L. Chan, MBBS, MBA, PhD, FRACP, AFRACMA, FAIDH, FCCP, FAPSR, FAIDH, CHIA, GAICD
Leadership in the Australian healthcare sector is a dynamic and evolving challenge, requiring a blend of clinical expertise, innovative thinking, and a deep commitment to patient care. Reflecting on my journey as a respiratory and sleep medicine physician, I believe that several key elements define effective leadership in this field.
Firstly, collaboration and interdisciplinary integration are vital. Throughout my career, I have seen the immense value of working across disciplines. My roles have spanned clinical practice, academic research, and healthcare management. This interdisciplinary approach not only fosters innovation but also ensures that patient care is informed by the latest scientific advancements.
Secondly, continuous learning and adaptability are crucial in a rapidly evolving healthcare landscape. My pursuit of higher qualifications in data science and business administration, alongside my medical expertise, underscores my commitment to lifelong learning. This adaptability is essential for addressing complex healthcare challenges and remaining at the forefront of medical and technological innovation.
Strategic vision and crisis management are also fundamental to leadership. During the COVID-19 pandemic, my team successfully transitioned to telehealth pulmonary rehabilitation models. This experience demonstrated the importance of flexibility, innovation, and swift, evidence-based decision-making in response to rapidly changing circumstances.
Additionally, my work in digital health and artificial intelligence reflects my commitment to integrating cutting-edge technology into healthcare, enhancing both patient care and operational efficiency.
Education and mentorship are responsibilities that I take seriously. As a clinical professor, I mentor doctoral research students, physician trainees, and medical students. By fostering a culture of continuous improvement, I ensure that future leaders in healthcare are well-equipped to advance the field and drive progress.
Finally, advocacy and community engagement are key components of effective leadership. My involvement in professional organizations, including my current role as secretary of the New South Wales and Australian Capital Territory Branch of the Thoracic Society of Australia and New Zealand (TSANZ), highlights my commitment to influencing healthcare policy and improving population health outcomes. I also lead the Sleep Health Clinical Academic Group at Sydney Health Partners and serve as an associate editor for the journal SLEEP Advances.
Collaboration, continuous learning, strategic vision, education, and advocacy are the cornerstones of leadership in healthcare. As the sector continues to evolve, these qualities will remain essential for leaders committed to advancing medical science and improving patient care.
Physician Burnout in Canada
Edgar G. Chedrawy, MD, MS, FRCSC, FACS, MHA, CPE, FAAPL, MCPDC
Although Canadians are proud of their publicly funded and publicly administered healthcare system, a 2021 survey by the Canadian Medical Association (CMA) revealed that more than 55% of physicians and medical learners experienced elevated levels of burnout.
Not only is this number alarming, but it represents an almost 50% increase for the same survey collected in 2017 (pre-pandemic). In fact, more than 60% of Canadian family physicians reported worsening mental health since the COVID-19 pandemic because of increased workload and lack of work-life balance.
Also, half of the surveyed physicians were considering reducing their clinical hours, retiring early, or leaving the medical profession altogether, compounding the already long wait times to see a family physician, a specialist, or seek urgent care in a hospital emergency department.
Insufficient financial, physical, and human resources are seen in provincial health systems nationwide.
Canadian physicians’ frustration stems from a sense of “learned helplessness” in not being able to influence change in their publicly funded system, even though Canadian physicians have multiple opportunities for leadership development and interaction with government at provincial and federal levels.
With respect to leadership development, Canadian physicians increasingly recognize the LEADS Framework as the standard for leadership development and healthcare. LEADS provides physicians with access to best practices, sets standards for development and accountability, and offers physicians opportunities for system wide leadership development.
Provincial medical associations, in collaboration with local universities, usually deliver leadership development programs to drive broad health system changes by equipping physicians with the necessary skills to lead effectively. Politically, physicians are registered with provincial regulatory bodies, such as the College of Physicians and Surgeons, which covers education, training, and quality of care standards.
Provincial health insurance plans also consult with physician colleges or physician focus groups to determine which services are medically necessary and should be covered by public health insurance plans. Physicians advocate with professional associations, such as the Canadian Medical Association, which works with government bodies to define health policy and advocate for the interests of patients and physicians alike.
During the COVID-19 pandemic, physicians collaborated closely with government agencies to advise on public health measures and assist with the implementation of set policies.
Even though Canadian physicians interact with the government at multiple levels (locally, provincially, and federally) and these physicians are well-trained in physician leadership competences, they are not able to influence the change necessary to meet the wants and needs of the Canadian health system and serve the public appropriately. The environment has become increasingly frustrating for them, leading to increasing rates of burnout and dissatisfaction with the Canadian health system.
Beyond Facts to Stories: The Heartbeat of Physician Leadership
Douglas Fahlbusch, MBBS, FANZCA, GDM, GAICD
I always assumed that I would be the doctor, not the patient, and that I’d live to be 103 like my grandmother. Mid-life cancer was my turning point, igniting a passion for improving healthcare. Navigating the complexity of investigations, surgery, and recovery as a healthcare “insider” made me wonder how “outsiders” cope. I also learned firsthand about duplicated effort, wasted time, and frustrations of outdated processes and technology.
Initially, I thought I’d need the answers, but the importance of asking the right questions has become obvious. Shifting from facts to stories has been transformative. I’ve realized the importance of emotional intelligence and the power of stories. Questions from patients and staff are an opportunity to cultivate a deeper emotional connection, enhancing team dynamics beyond the transmission of information.
Researching my book Reimagining Healthcare taught me to transcend simplex thinking and embrace complexity theory and systems thinking. By incorporating meaningful stories from patients and staff, we can drive enduring innovation with less resistance to change. Stories are more than narratives; they create connections and foster transformation by touching both the heart and the mind.
Not content with one patient experience, nine years later, I suffered multi-trauma. Again, I had time to contemplate with three months off work. I was struck by the differences: cancer was a psychologically more difficult recovery, while trauma was a physically more difficult recovery.
Sadly, I was also surprised by the similarities: healthcare felt no safer, cheaper, or easier to navigate.
Then, I set up a cross-discipline working party at my hospital, where understanding each other’s roles through stories of good days and bad led to more collaborative care and improved staff and patient satisfaction. These are key factors in a post-COVID world, where staff attraction and retention are difficult and hospital margins are under pressure.
Physician leadership in Australia presents unique opportunities and challenges. Hospital healthcare is approximately 50:50 between public and private hospitals, with funding about 30% from each of federal government, state governments, and private insurance. Perverse incentives abound. We are grappling with a nascent change to value-based care.
Effective physician leaders are storytellers, systems thinkers, and are emotionally intelligent. They continuously engage with peers to move beyond simplistic thinking and toward an integrated, compassionate approach to healthcare. To create a safe, efficient, and deeply humane healthcare system, we need to foster these traits in our healthcare administrators and fellow physicians.
Physician Leadership in Australia
Neale Fong, MBBS, GradDipCS, MTS, MBA, MRACGP, FAICD, FCHSM, CHE
I commenced working as a doctor 41 years ago and have had the immense privilege of working in a wide number of roles in health systems. Starting in sexual health medicine and only three years out of medical school, I was given the task of establishing our government’s first HIV/AIDS assessment clinic. This was in 1985 at the crescendo of HIV cases in Australia. It taught me many lessons about people management, but more than anything, about the need for empathy — something that I have tried to live and breathe in my health leadership journey since.
Taking time out of medicine to do a master’s degree in theological studies was also a slightly different preparation for health management, but again enabled me to build a broader foundation of understanding people, organisations, and how to create networks of people. The most important lesson from this time was the centrality of building a legacy of leadership through the intentional development of leaders, thus building multiplier effect for leadership succession.
Knowing I needed more technical skills, I studied part-time for an MBA, then embarked on consulting roles (establishing our state’s first CDC unit), and then into a role as the CEO of the Western Australian Government Health Department.
As the CEO was non-medical, I learned the hard way how to handle media and multiple stakeholders, especially colleague managers, who were also not medical. However, ensuring that everyone has an equal spot at the table is critical, and although clinicians bring a particular perspective, they need the nonclinical inputs and expertise as well. Otherwise, an arrogance can creep in that the “doctor always knows best,” and we know that’s simply not true.
My career then led to leadership of our state’s largest private hospital at the time, where a turnaround strategy was required. I learned quickly that doctor engagement is the key to life as a private hospital CEO. Although the patient and the quality of care are always paramount, without the medical workforce (who can voluntarily choose to work in your facility), you won’t be successful.
After six years in the private hospital, I was asked to lead a major reform implementation in our government health system. It meant building a team from scratch and then developing a simple and focused plan that provided vision but, more importantly, buy-in from all parts of the system, including our partners in the private and NFP sectors.
Central to the success of the implementation was again the focus on leadership development with an Institute of Health Leadership being established. Twenty years later, it is remarkable how many leaders still refer to the importance of these intentional programs in their own career journeys.
I now manage a portfolio life of board chair and executive roles, work in advisory consulting, and am the leader of the Australasian College of Health Service Management (ACHSM), which is the peak continuing professional development organisation for 2,500 health leaders across Australia, New Zealand, and Hong Kong.
I am privileged to continue to be on a journey of bringing clinicians and nonclinicians together to create and execute policy; build effective partnerships across public, private, and not-for-profit sectors; and attempt to create better service integration (primary care, aged, and community care) with a strong emphasis on the digital transformation agenda.
Physician Leadership in Canada
Matma Gautam, MD, MBA, FRCPC, CCPE, CPE
Canada is very fortunate to have many strong physician leaders. Since 1998, the Canadian Society of Physician Leaders, the CSPL, has been inspiring physician leaders and providing support and development opportunities for Canadian physicians to succeed in their leadership and management roles in healthcare.
I am grateful to have had the privilege to serve on the CSPL board of directors for many years, stepping down just this past spring. During this time, the CSPL has partnered with many medical organizations; designed and delivered innovative leadership development curricula; supported a white paper, “Accepting Our Responsibility: A Blueprint for Physician Leadership in Transforming Canada’s Healthcare System”; conducted key research on physician leadership in Canada; and supported physician leaders during the COVID-19 pandemic.
This august community of peers has been a source of inspiration, support, mentorship, sponsorship, and professional growth for me.
My own journey as a physician leader was founded on my ongoing desire to be an advocate. I have always been one to stand up and speak out for the rights of others — in high school on the student executive, in medical school as class president, as the intern representative, and in my role as chief resident.
I completed my residency in psychiatry and a fellowship in child and family psychiatry. In 1990, as I was setting up a practice in child psychiatry, I was asked at the last minute to fill in as a speaker at a medical conference and decided to speak about depression, as I had just spoken to the residents about the topic and my slide carousel was ready.
After the presentation, three colleagues asked if I would see them as patients. Word of mouth spread and within three months, working with physician colleagues became my entire practice focus. I soon appreciated the extent of physician distress, realized that healthcare does not always care about the health of its providers, and recognized the need for advocacy in this area.
Over the years, I accepted invitations to speak at rounds, conferences, and meetings to raise awareness of the topic of physician well-being and discuss solutions — known as “the doctors’ doctor.” I served in leadership roles in several national and provincial medical organizations to advise on issues related to physician well-being.
In the past two decades, I have expanded my work to include physician leadership development, to enable more physicians to be leaders and better address system-level factors that affect the well-being of healthcare workers. A certified LEADS Global facilitator, I have the privilege to deliver keynote presentations and workshops and offer consultation to healthcare organizations internationally.
A specific area of interest for me is addressing the gender leadership gap in medicine. I am committed to advancing diversity in medicine and facilitating leadership development for women in medicine through a number of programs. I am dedicated to doing my small part to leave the world of medicine better than I found it.
A Perspective from St. Kitts and Nevis, East Caribbean
Patrick Martin, MD
The Federation of St. Kitts and Nevis has a population of 53,000. As is the case in all small island states, human capital is the leading factor in socio-economic growth and development. Good self-reported health and well-being is paramount, and excellence in population health and personal medical services is uppermost on the minds of voters.
St. Kitts and Nevis is categorized as having “high human development” in the 2023-2024 U.N. Human Development Report. Furthermore, national reports document the achievement of health-related targets of the U.N. Sustainable Development Goals (goal #3) with respect to maternal mortality, younger than-5-years child mortality, and infant mortality.
In St. Kitts and Nevis, the practice remit of a physician leader encompasses the immutable forward and backward linkages between health status, essential public health functions, and development. Critical topics include research paper analysis, technical writing, service design, performance assessment, health financing, effective communication, negotiating, teamwork, and meeting management.
Knowledge and skills are acquired and enhanced through the training auspices of the AAPL; kindred organizations greatly facilitate collaboration with and mentorship of colleagues in administration and clinical care. Thus, the DNA of health leadership is constantly reinforced by the championing of teamwork, decision-making based on data and evidence, and effective preparation to deliver robust policy positions.
The major challenge is to sustain health progress against the backdrop of mounting threats and risks. Principal among them are obesity, pandemic-potential pathogens, and the climate crisis. Direct and indirect costs of obesity-related, non-communicable disorders consume approximately 50% of total national health expenditure.
The COVID pandemic caused a 15% contraction in the economy, putting severe strain on government funding of essential healthcare services. Similar economic downturn is occasioned by direct and indirect effects of cyclones, which is illustrative of the substantial cost of climate crisis mitigation and adaptation.
Knowing the existential threats, the government has adopted a Sustainable Island State Agenda. This is the principal framework for transformative action whose strategic intents are sustainability, resilience, and survival. Vulnerabilities and challenges spell opportunities to think and work smarter. In that regard, the skillsets of physician leaders are relevant and contribute to innovations in health security and social protection.
Key policy advice and results areas include leveraging strategic health information to enhance universal health coverage and access, medium- to long-term resource (human, health commodities, funding) sufficiency, and beneficial health partnerships.
Evidence-based and collaborative approaches continue to demonstrate improved service quality and improved population health outcomes.
Education and Research for Physician Leaders in Japan
Yoshinori Nakata, MD, MBA, PhD, CPE, FAAPL
A scholar and an educator, I have been an AAPL member for 20 years and have been teaching healthcare management and economics in Japan for more than 10 years.
I began my medical career in 1990. After earning my MD at the University of Tokyo, I trained as an anaesthesiologist at Massachusetts General Hospital. I was very much surprised at the difference in practice patterns and healthcare systems between the United States and Japan. For example, more than 50% of all surgeries were outpatient surgeries in the United States, which is exceptional in Japan.
I earned my MBA at Yale University and then returned to Japan, where I was appointed executive vice president at Teikyo University Chiba Medical Center, which had 550 beds and served 300,000 people in Chiba, Japan. I supervised the implementation of the medical information system and newly established emergency medical system at Chiba Medical Center.
Our healthcare system in Japan has offered universal health insurance coverage for more than 60 years. The Japanese people and politicians like the system because they can receive healthcare any time at affordable costs.
Fortunately, unlike the United Kingdom, Japan does not have “waiting lists” problems. However, the sustainability of our healthcare system is questionable; we face the problems of low birth rate and declining population, which are common in developed countries.
The long working hours of healthcare professionals have been prevalent, and working overtime has been more strictly regulated since April 2024. The healthcare budget is increasing rapidly despite any efforts to contain it. I am still not sure whether the market-oriented healthcare system is better for our patients than the heavily regulated system in Japan.
After my vice presidency, I joined the faculty at the Graduate School of Public Health of Teikyo University and started my career in research and education. My research focuses on the productivity and efficiency of healthcare, with special emphasis on surgical care. I have published papers on this topic, which I hope to be of use to physician leaders.
Education is my other passion. I enjoy educating future leaders in healthcare and public health. The students are mostly Japanese, but some students are from the United States, the Philippines, Thailand, Malaysia, Taiwan, and China. I teach them in both Japanese and English.
I also work as an anaesthesiologist with my residents and fellows in the operating room. Although I currently have few administrative duties, I enjoy this combination of research, education, and clinical work because I am building the future of our healthcare system.
Exploring Physician Leadership: A Comparative Journey in the Global South
Nandakumar G. Pillai, MBBS, MRCGP, FRCP(Edin), FFOM, FRCPI, MBA
When I began my professional journey in India, I wholeheartedly committed myself to making a difference in a demanding rural/semi-urban healthcare environment with limited resources.
As a medical professional who had completed a rigorous medical school curriculum and residency, I maintained a strong focus on outcomes, exhibited rapid learning capabilities, demonstrated a robust work ethic, held high expectations, and had the confidence to address patient needs at a modest health center.
My transition to working at a health center serving more than 35,000 residents with limited resources and infrastructure in a developing country provided me with a stark reality check. The patients’ perspectives, concerns, and anticipations significantly contrasted with those I had previously encountered in the hospital setting during my medical school tenure.
Because of the deeply entrenched beliefs, behaviors, and customs within the society, it is imperative for any physician working in this environment to demonstrate cultural sensitivity and possess knowledge of local customs and traditions. I eagerly embraced the chance to learn, adjust, and thrive and soon recognized the critical significance of cultural awareness, patience, and flexibility in earning the trust of rural communities.
This experience was profound and fulfilling, requiring me to be an adaptable problem-solver with unwavering resolve in the face of challenges. Thus, in my transition from clinical to leadership roles, although I encountered initial challenges, I could successfully spearhead substantial improvements in health service delivery within a small-team environment.
Approximately 18 years ago, in the second phase of my career, I moved to the Middle East to work with Qatar Energy. It was a pivotal experience to become part of a substantial team comprising approximately 40 physicians and 250 nurses and paramedics in a nation with notably high per-capita income.
Despite my accomplished background in a smaller team setting, I encountered challenges pertaining to decision-making and leadership. This compelled me to recognize the necessity for a more extensive, collaborative approach to steer strategy, amalgamate clinical practices, and instill motivation in teams to foster enduring enhancements.
The insight gained from my leadership cohort highlighted that success hinges on establishing systems that empower individuals to resolve their challenges. As a leader in the medical profession, I acknowledge the significance of harmonizing personal and organizational conduct with ethical and professional standards, along with the capacity to instill a culture of excellence and manage change adeptly to accomplish strategic aims.
This experience sharpened my proficiencies in communication, cultivating visionary goals, and ethical leadership, positioning me to drive substantial transformation in healthcare management.
Physician Leadership in Canada: A Journey of Innovation and Collaboration
Eduardo Portela de Oliveira, MD
As a physician leader in Canada, my journey has been shaped by an intersection of clinical practice, academic leadership, and research innovation. Serving as the director of undergraduate medical education in the Department of Radiology of the University of Ottawa and clinician investigator at the Ottawa Hospital Research Institute, I have experienced firsthand the critical role of leadership in shaping the future generations of physicians while advancing innovative projects that address the evolving challenges of healthcare today.
One of the defining elements of my leadership experience has been the integration of cutting-edge technology in educational and clinical settings. My work developing virtual reality (VR) tools for medical education and artificial intelligence (AI) applications in medical imaging exemplifies how physicians can lead innovation in healthcare.
These initiatives, supported by national and international collaborators, highlight the crucial role of physician leaders in driving technological advancements that enhance training and improve patient outcomes.
Despite the benefits of innovation, leadership within the Canadian healthcare system comes with its own set of challenges. As in many other regions, physicians here often face systemic barriers to leadership, including complex administrative structures and limited time or compensation for leadership roles. However, the emphasis on leadership training is growing, with Canadian institutions increasingly recognizing the need for physicians to develop management and administrative expertise alongside their clinical skills.
Programs offered by the Canadian Society of Physician Leaders, the Royal College of Physicians and Surgeons of Canada, and the Canadian Medical Association are critical to empowering physicians to take on leadership roles in this rapidly changing landscape.
Additionally, academic programs provide advanced leadership education, ensuring Canadian physicians can navigate complex healthcare environments and drive systemic change.
Collaboration has also been a key pillar of my leadership journey. These connections provide valuable insights into diverse approaches to leadership, helping to shape strategies adaptable to local contexts while remaining aligned with global trends. Engaging with leadership communities across borders enriches our shared understanding and enables the collective advancement of physician leadership worldwide.
As we continue to face complex challenges in healthcare locally and globally, the role of physician leaders will be central in fostering innovation and collaboration. By embracing these responsibilities, we can contribute to meaningful advancements in healthcare delivery and improve the systems that serve our communities.
My Journey in Physician Leadership
Luis Prado, MBBS, FRACGP, FRACMA, FACHE, FCHSM, FACMQ, GradDipSpMed
The Australian healthcare system is one the nation as a whole can be justifiably proud of, based on Medicare ensuring free public hospital care throughout the country.
However, the challenges facing both the public and private healthcare sectors in terms of the ever-growing demand for services, workforce shortages, and rising costs for the delivery of care means that now more than ever, physicians are asked to take on leadership roles.
As a healthcare system physician leader for 30 years, I have considered developing and growing the next generation of physician leaders as one of my key responsibilities.
I believe that unless you have a purposeful plan to develop physicians as leaders and provide the opportunity for growth training, education, and experience in leadership roles, then you cannot expect that physicians will simply “step in” when called forward to lead.
This is particularly the case for physicians from diverse and marginalized backgrounds who are often overlooked for such opportunities unless “sponsored.” Such sponsorship includes simply sitting down with these physicians and highlighting their skills, discussing their future, and encouraging them to consider applying for leadership opportunities.
Highlighting to physicians who have not considered taking on “leadership” that they demonstrate leadership skills every day as a clinician in how they interact with colleagues is an approach I found to be very successful.
Physicians are often unaware that when they “set the tone” in the delivery of safe, high-quality care, they are demonstrating key leadership skills that are transferable to other leadership situations.
For a physician leader, using formal and informal opportunities to grow the next generation of leaders is key to such a plan. Whether it be through nominating physicians to committees, supporting their attendance at leadership workshops and seminars or more formal training programs such as through the Royal Australasian College of Medical Administrators, as a physician leader, I encourage and support physicians to develop their skills and contribute to meeting the challenges facing our health care system.
Physicians have a unique and vital opportunity to influence and drive change and improvement, and developing physician leaders is a way to enhance the input of the profession.
Global Trends in Physician Leadership: The Journey of a Visionary
Ragupathy Veluswamy, MD, MMM, CPE, FACPE
The landscape of physician leadership is undergoing a remarkable transformation, not just in the United States but across the globe. Through four decades of working in various capacities, from a junior physician to a vice president in renowned U.S. hospitals, and later as the chief executive officer of G. Kuppuswamy Naidu Memorial Hospital (GKNMH) in India, I have witnessed firsthand how the roles and responsibilities of physician executives have evolved. This evolution has not only influenced healthcare delivery, but has also redefined the very essence of leadership in medicine.
My journey began in the United States, where the American Association for Physician Leadership (AAPL) provided me with the education and tools necessary to grow steadily in my career. In 2015, I returned to my roots, joining GKNMH, a hospital established in 1952 by G. Kuppuswamy Naidu to serve the community with affordable quality medical care.
Like many countries, India has a dichotomous healthcare system, split between the public and private sectors. In the public sector, career advancement for physicians is often tied to seniority, while in the private sector, especially in recent years, appraisal scores are increasingly used to determine promotions. Despite these advancements, there remains a significant gap in the formalization of physician executive roles and networks, a challenge that many nations face.
The hospital’s daily operations begin with a “flash meeting” of department heads, during which we review the positive aspects of our functions, address challenges faced in the last 24 hours, and brainstorm solutions. The central focus of all our activities is the patient care experience.
Recent infrastructure developments, such as executive patient rooms with state-of-the-art facilities and a robust design strategy during the COVID-19 pandemic, have significantly improved our ability to manage patient flow and provide high-quality care under challenging circumstances.
Looking ahead, my vision includes creating a “smart hospital” that represents a paradigm shift from disease treatment to health management. This vision encompasses wellness, healthy living, disease prevention, rehabilitation, and digital health enablement for patients.
We implemented telemedicine services, iOS-based electronic medical records, and specialized care delivered by credentialed health personnel, GKNMH is poised to lead in the next generation of healthcare delivery.
One of our most ambitious projects has been the creation of a state-of-the-art integrated outpatient center in Coimbatore, which redefines patient care by offering comprehensive services under one roof.
GKNM Hospital’s vision for the outpatient service transcends the boundaries of conventional healthcare, aiming to provide comprehensive, convenient, and patient-centric care. Our commitment to holistic healthcare encompasses all medical disciplines, including alternative therapies.
This center, recognized in the Asia Book of Records as the largest of its kind in Asia, ensures that patients can complete all necessary tests, lab work, and consultations in a single visit, setting a new standard for convenience and efficiency in healthcare.
Our commitment to extending care beyond the hospital walls led to the launch of a comprehensive homecare program, which includes visiting nurse services, telemedicine consultations, and prescription delivery. This initiative reflects our dedication to providing holistic, patient-centered care, no matter where our patients are.
Through these combined efforts, GKNM Hospital has transformed from a specialty hospital into a super-specialty healthcare center renowned for its comprehensive patient care, advanced technology, and strong academic focus. Our journey continues as we strive to maintain and enhance our position as a leader in healthcare, both in India and on the global stage.
As I reflect on the trends in physician leadership, it is clear that the role of physician executives is becoming increasingly vital in shaping the future of healthcare. Whether in India, the United States, or anywhere else in the world, the key to successful healthcare leadership lies in the ability to innovate, inspire, and implement strategies that improve patient outcomes, empower physicians, and create environments where employees can thrive.
The journey of physician leadership is one of continuous learning and adaptation, driven by a passion for making a difference in the lives of patients and communities.
My Physician Leadership Journey and Work in Australia
Sid Vohra, MBBS, MBA, MHM, FRACMA, FCHSM CHE, AMP, GAICD, CPE
I am a chief medical officer at Orange Health Service with responsibility for one of Australia’s largest regional health facilities. The town of Orange, where I live and work, is about three hours west of Sydney and characterised by sparse farmland, rolling green hills, high-altitude vineyards, and a vibrant city center where healthcare, tourism, wine-making, and mining are the major industries.
Our system has all specialty services in-house except for neurosurgery and cardiothoracic surgery, with more than 200 of our specialist doctors living and working in our town.
The leadership capabilities required for my role include specialist medical services management, operational excellence, financial budget accountability of $50 million, and line management of clinicians. I also strive to develop stakeholder relationships at the community, state, and federal levels in matters relating to healthcare systems.
In Australia, specialist doctors in medical leadership are Fellows of the Royal Australasian College of Medical Administrators (FRACMA). My learning experience from AAPL’s CPE program in 2023 complemented my RACMA training and allowed me to progress my development and growth as a leader.
The ability to interact with colleagues from the United States and learn about challenges faced by CMOs working in the provider and payer space has allowed me to adopt a more strategic approach to my operational executive role in the hospital. This also led me to complete my company directors qualification from the Australian Institute of Company Directors (AICD) and pursue advisory and governance roles in large businesses to further enhance my commercial leadership skill set.
I previously was a member of the board quality advisory committee for the Royal Flying Doctor Service in Australia. I currently sit on the board of integrated living Australia, a national home and aged care service provider, and am a clinical and commercial adviser to Teladoc Health’s Australia and New Zealand business maintaining a close relationship with U.S. business.
I also am an editor of the American Journal of Medical Quality, as this allows me to maintain my critical appraisal skill sets and to learn about cutting-edge research and evidence-based quality governance initiatives in the U.S. healthcare system.
In 2022, I completed the advanced management program (AMP) at The Wharton School of the University of Pennsylvania. Learning about best practice management, adaptive leadership, negotiation, and strategic planning in complex business structures from world-leading professors and gaining a network of friends from all over the world was a fantastic experience.
I greatly enjoyed living in Philadelphia within the scenic and leafy Steinberg Conference Center on the Penn campus and learning about the fascinating history of the city as well as experiencing its sporting culture. Talking to American friends about Australian football, our unique national game here, and comparing it with football in the United States was particularly enjoyable.
In addition, I learned at Wharton about the Penn Medicine multi-hospital organization, its leadership, and the innovative advancements in clinical medicine and research from this leading health system.
I continue to read about innovation, management, and leadership from a variety of sources, including Wharton and AAPL’s Physician Leadership Journal.
Taking on a CMO role in healthcare does not in itself indicate full development of healthcare management and leadership capabilities. Instead, it is a pathway of commitment to lifelong learning, and I find great value in both contributing to thought leadership initiatives and learning from colleagues to improve my own skills, as well as reflecting on my leadership approach.
I look forward to continuing my affiliation and further increasing my involvement with AAPL.