Health care organizations commonly elevate top clinicians into leadership roles, but clinical expertise does not automatically equip physicians to manage the business and organizational demands of those positions. That is the central message from Kate Atchley, Ph.D., professor of practice at the Haslam College of Business at the University of Tennessee, Knoxville. In a Medical Economics special report podcast published October 13, 2026, Atchley explains why physicians need an expanded set of competencies if they are to lead effectively across complex systems.
Atchley directs Haslam’s Executive Master of Business Administration in Healthcare Leadership and Physician Executive MBA programs, and she draws on that experience to describe the practical gaps clinicians face when moved into roles that require decisions about capital allocation, payer economics and organizational change.
Atchley says the most notable shift over the past ten years is how interconnected health care problems have become. Leaders increasingly encounter situations in which moving one lever affects several others. In the interview she gives examples of real trade-offs leaders face: clinician autonomy versus standardization, and patient access versus clinician workload. These are presented as two valid priorities that often pull in opposite directions and require leaders to balance competing organizational aims.
Atchley lists five skills she considers essential for physicians who want to lead beyond their clinical roles. She frames these as complementary areas that together help leaders see trade-offs, influence others, and manage change.
Systems thinking: The ability to view the organization and its problems as interconnected parts rather than isolated issues. Systems thinking helps leaders anticipate ripple effects when they change policies, workflows or incentives.
Business fluency: A working understanding of finance, operations and strategy so clinical leaders can evaluate trade-offs and make informed decisions about resources and performance.
Leading through influence: Most physician leaders do not lead by formal authority alone; they must persuade colleagues, build coalitions and gain buy-in to change practice or policy.
Change leadership: Experience and skills in planning, communicating and implementing change, including managing resistance and aligning stakeholders around a new direction.
Curiosity: An openness to learn about other parts of the organization and to ask questions that reveal unseen connections and opportunities.
Atchley stresses that clinical expertise in a single domain is necessary but not sufficient for leading across many domains. In practice, physician leaders must broaden their knowledge and their approaches to decision-making.
To avoid placing unprepared clinicians into leadership roles, Atchley recommends that organizations cultivate leaders before they step into formal positions. Her suggested approach includes spotting potential leaders early and assigning them progressively harder tasks that increase responsibility and complexity. She also advises exposing promising staff to other parts of the organization so they develop cross-functional awareness and context.
These steps create a pipeline of leaders who have seen multiple facets of the enterprise and who have had opportunities to practice decision-making, collaboration and change management on a smaller scale before taking full charge.
For physicians aiming to shape how their organizations are run, Atchley offers a concise directive: “get out of your lane.” She urges clinicians to learn enough about finance, operations and strategy to understand the trade-offs leaders must weigh. That baseline fluency enables clinicians to participate more effectively in discussions about resource allocation, clinical standards and access.
By expanding their scope of knowledge and seeking cross-departmental experiences, physicians can contribute to solutions that balance clinical quality with operational realities.
The Medical Economics special report episode was organized with timestamps and an AI-produced transcript. The episode flows from introductions (0:00–1:19), a profile of Atchley (1:19–2:21), and a discussion of how health care leadership has changed (2:21–3:25). Additional segments cover why clinical expertise isn’t enough (3:25–5:07); choosing between valid priorities (5:07–6:58); the five essential leadership skills (6:58–10:23); building a leadership pipeline (10:23–11:49); and Atchley’s advice to clinicians to broaden their knowledge (11:49–14:01). The program concludes with closing remarks and an outro.
Editor’s note in the source indicates that timestamps and the transcript were produced using AI tools. Beyond the interview content and the episode structure, the source did not provide additional data, examples, or implementation specifics about the programs Atchley directs.
The core takeaway from Atchley’s remarks is practical rather than ideological: leading health care now requires a broader toolkit than clinical training provides. As organizations juggle clinician autonomy, standardization, access and workload, leaders must make trade-offs that reflect both patient care goals and organizational sustainability. Equipping clinicians with the five skills Atchley names can help institutions reduce the risk of promoting individuals into leadership roles without the preparation to handle those trade-offs.
For health systems and practices, adopting structured leadership development—spotting talent early, assigning graduated responsibilities and creating cross-functional rotations—offers a way to build leaders who can navigate complexity. For individual physicians who want influence, investing time to learn finance, operations and strategy can improve their ability to engage in those conversations and affect policy and practice decisions.
The source article does not report specific next steps for Haslam’s programs or for employers beyond the general recommendations Atchley offered in the interview. It suggests, however, that organizations serious about leadership quality should create intentional pipelines and provide opportunities for clinicians to learn the language and mechanics of health care management. Those actions, according to Atchley’s guidance, are foundational to preparing physicians to lead in an increasingly interconnected system.
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