CEO and Owner, Digestive Diseases and Nutrition Center

Dissertation Title

Employment of Physician Administrators (CEOs) in Acute Care Hospitals and Their Impact on Hospital Performance

Dissertation Abstract

This study examines the performance of hospitals employing physician CEOs. It compares the performance of these hospitals to hospitals employing non-physician CEOs in the same regions.

The study evaluated clinical outcome variables including mortality and readmission rates in addition to patient safety index. The study also evaluated average expense per inpatient discharge as well as adjusted operation margin as measures for financial performance. The hospital scores on these measures were compared using an independent sample t-test to compare the means of the two groups of hospitals for significant differences in performance. Multiple regression analysis was conducted for this comparison controlling for: teaching status, bed size, tenure, and geographic region, which were treated as covariates. The results showed a statistically significant difference (p <.05) between physician and non-physician led hospitals in acute myocardial infarction (AMI), heart failure (HF), and pneumonia in the scores of the 30-day adjusted mortality rates, which was lower among hospitals with physician CEOs. Also, patient safety index (PSI) was favorable and lower among hospitals with physician CEOs and statistical significance at (p < .05). Even though the average expense per inpatient discharge was higher, which was unfavorable in hospitals with physician CEOs and statistically significant at (p <.05), the operation profit margin was higher among physician led hospitals but not statistically significant.

This is the first quantitative study to compare clinical and financial outcomes performance between physician-led and non-physician-led hospitals. This research can guide hospital boards when they hire CEOs. The hospital which is financially sound but needs to improve in its quality regarding the reduction of mortalities and increase its safety may benefit from hiring a physician CEO.

Additional research is needed to: address the limitation of the study, test a larger pool of physician CEOs, and compare physician CEOs with non-physician CEOs who have effective CMOs and the leadership characteristics of effective CEOs in hospitals. This research must compare in more comprehensive detail the two groups. Schools of Health Professions can take the lead in such research and can fill the gap by educating and preparing leader physicians for their new role as CEOs.