Beyond the Bedside: Operational Excellence as a Core Competency for Physician Leadership
Physicians are uniquely positioned to lead healthcare into the future. Yet most were never formally trained to lead, particularly in operations.
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Physicians are uniquely positioned to lead healthcare into the future. Yet most were never formally trained to lead, particularly in operations. Concepts such as throughput, resource allocation, LEAN methodologies, staffing ratios, and financial stewardship tend not to appear in medical school curricula; however, that has been changing in recent years.
In today’s increasingly complex healthcare environment, physician leaders must not only understand clinical care delivery; they must also shape how care is delivered—safely, efficiently, equitably, and with an eye on the financial implications for the organization. To succeed, physicians must cultivate an operational lens that complements their clinical expertise, relational skills, and self-awareness. The key is to gain an appreciation of operational excellence, with a focus on creating systems where the organization can prosper and patients consistently receive outstanding care.
As operational excellence guru W. Edwards Deming stated, “Every system is perfectly designed to get the results it gets” and this statement underscores the importance of continuously discovering smarter, more efficient ways of working — and embedding those improvements into the fabric of the organization. The work of physician leaders is to ensure those systems deliver the right results—high-quality care, reliable outcomes, and sustainable performance. This requires a disciplined mindset: questioning whether existing processes add value, redesigning those that do not, and embedding a continuous improvement focus into the culture of the organization.
Why Physicians Must Take a Lead in Operations
Healthcare organizations that expect leaders to apply operational excellence mindsets reap enormous benefits. Delivering care reliably, efficiently, and at scale requires systems thinking, continuous improvement, cost discipline, and alignment between clinical operations and strategic priorities.
Physicians are uniquely suited to lead this work because they see firsthand where systems break down. They observe delays, bottlenecks, duplicative steps, and unintended consequences that others may miss. Conversely, they may be the first to recognize opportunities for innovation, change, and improvement.
When physicians are engaged in operational redesign, outcomes improve—for patients, staff, and the organization alike. Conversely, when they are absent, even the most well-intentioned improvement initiatives often falter. Inefficient workflows and broken systems are not only costly but also often lead to burnout among healthcare workers.
Physician leaders also bring credibility, context, and the ability to integrate the importance of the patient experience and performance metrics. Their ability to influence both administrative leadership and frontline staff is an important component in leading change efforts related to operational excellence and continuous improvement. Their involvement ensures process improvements are organizationally relevant, clinically sound, and operationally sustainable.
The Operational Excellence Skill Set for Physician Leaders
Operational excellence in healthcare is maximized when physician leaders remain attuned to the following operational concepts:
- Systems thinking: Understanding end-to-end patient flow and interdependencies
- Data-driven leadership: Gaining fluency in dashboards, KPIs, cost drivers, and outcome metrics
- Continuous Improvement: Identifying inefficiencies and root causes in workflows
To lead effectively, it’s essential for leaders to balance attention between operational elements—such as processes, tactics, and data—and the human aspects of execution. When the focus is solely on the former, the result is often mere compliance with expectations. However, achieving long-term operational excellence requires genuine commitment. That commitment is cultivated when leaders invest time in addressing the people side of execution, which includes:
- Collaborative leadership: Working cross-functionally with nursing, administration, IT, finance, and other areas
- Change leadership: Communicating the “why,” addressing resistance, and recognizing progress
- Communication and presence: Remaining visible and engaging frequently with colleagues to ensure alignment and foster momentum
When organizations have leaders focusing on these concepts, proven successes demonstrate the impact: optimized patient panels, increased operating room productivity, shorter emergency department wait times, reduction in medication errors, and fewer redundancies in documentation. Once operational excellence becomes embedded in an organization, opportunities for improvement surface naturally and multiply quickly.
Building the Muscle
So how can physician leaders strengthen their operational acumen? A few proven approaches include:
- Reading: Foundational texts and healthcare-specific resources provide a solid base. (See our Reference List below.)
- Coaching: Partnering with a coach versed in operational excellence accelerates learning and builds confidence.
- Case-based learning: Real-world examples across healthcare reveal strategies that can be adapted and scaled to the physician leader’s organization.
- Peer cohorts and mentoring: Shared learning and real-time observation of ongoing initiatives create invaluable opportunities for professional growth. Physician leaders can also catalyze organizational change by serving as mentors and sponsoring process-improvement initiatives.
The key is practice: developing fluency by applying concepts directly to daily challenges, even small ones, learning from feedback, and refining approaches over time.
The Road Ahead
As should be apparent, healthcare’s long-term viability depends on operational excellence. For physicians, leadership means walking in two worlds: one dedicated to healing individuals, and one committed to continuously healing the systems that deliver care. The physician leader of the future is not only a clinician and advocate, but also a systems thinker and operational architect. Those who embrace this dual role will be best positioned to create organizations where patients, providers, and communities can thrive.
References
- Agency for Healthcare Research and Quality (AHRQ): Lean Six Sigma and Quality Improvement Tools.
- AMA Steps Forward® Toolkit on Team-Based Care and Workflow Redesign.
- Bohmer, R.M.J. “The Hard Work of Health Care Transformation.” New England Journal of Medicine.
- Swensen, S., Dilling, J., Harper, C., & Noseworthy, J. “Organizing the US Health Care Delivery System for High Performance.” Health Affairs.
- Toussaint, J. & Berry, L.L. “The Promise of Lean in Health Care.” Mayo Clinic Proceedings.
