Marc Shelton, MD, an associate professor of cardiology at the University of Missouri Health System in St. Louis recently joined Becker’s to share seven reasons that physicians leadership is on the decline:
Editor’s note: Response has been edited for clarity and length:
Question: What’s keeping physicians from leadership roles in 2025?
Dr. Shelton: 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.
