in many countries are navigating an era of accelerating complexity, defined by financial pressures, shifting demographics, and evolving consumer expectations and care delivery models. To meet this moment, CEOs will need to guide their organizations through a period of reinvention and reimagination—in service of achieving both mission and margin.

Physicians may be well suited to answer this call, bringing with them a desire to improve patient care and the strengths of clinical training. In our recent McKinsey Physician Leadership Survey, more than half the respondents cite an interest in broadening their impact on patients as a top motivator for expanding their leadership mandate (see sidebar “Research methodology”).¹ And given the CEO role’s unmatched ability to shape enterprise direction and patient outcomes at scale, it’s not surprising that many of these physicians aspire to lead from the CEO’s seat.

In fact, nearly 60 percent of surveyed US physician leaders expressed interest in becoming a CEO—a striking contrast to the roughly 15 percent of healthcare CEOs in the United States today who come from clinical backgrounds.² This ambition prompts a consequential question for the future of healthcare: How can this aspiration be harnessed so that the next generation of physician CEOs can successfully deliver both health outcomes and enterprise performance?

This article is the first in a series that will address this question. Building on decades of McKinsey research on how to support CEOs across the four seasons of their tenure and on what defines CEO excellence across industries (see sidebar “CEO excellence”), we turn our attention here to an extraordinary yet often underrepresented group of leaders: physicians. Our conversations with US physician and nonphysician healthcare and life sciences CEOs, CEO coaches, executives, and executive recruiters reveal that there is significant untapped potential for physicians to enter their next specialty and lead healthcare and life sciences as future CEOs

Cultivating the pipeline of physician leaders requires closing the skills gaps by building business and leadership experiences, which are often overlooked in conventional medical training; addressing the challenges that arise from perceptions of physicians’ capabilities; and unlocking physicians’ leadership potential by honing the strengths gained through clinical training.

Skills and experience gaps along with perception barriers—specifically, negative external perceptions about physicians’ business or leadership skills—are the  top self-reported challenges to transitioning into leadership positions, according to our survey respondents (60 percent and 52 percent, respectively).³ Indeed, many physicians enter the workforce in their thirties after years of intensive training but with limited exposure to business practices. By contrast, their nonclinical peers have typically spent years working with budgets and building strategic experience.

Limited business fluency results in a self-reinforcing cycle. In our survey, physician leaders acknowledge that they have gaps in financial, strategic, and market-based knowledge.⁴ This was reiterated in our conversations with CEOs and other executives at healthcare and life sciences organizations. They noted that concerns—from both physicians and nonphysicians—about a lack of business acumen restrict opportunities, which in turn hinders skill development. As a result of this vicious cycle, many physicians are left in clinical leadership roles even when they have the capacity and aspiration to lead beyond the clinical realm.

Differing perceptions of leadership skills lead to divergent views on preparedness for advancement. Survey respondents report great confidence and experience in operational excellence, leading large teams, and strategic expertise.⁵ On the other hand, CEOs, physician coaches, and executive recruiters we spoke to often cite these very leadership skills as essential to round out physicians’ profiles. This difference in perception may result in physicians missing or not pursuing leadership opportunities while CEOs remain concerned with physicians’ readiness for nonclinical enterprise-wide roles. Closing this gap requires intentional leadership training akin to the focus physicians apply to their clinical training.

The instincts developed through years of medical training—while essential to delivering high-quality patient care—can be a double-edged sword for enterprise leadership. When appropriately harnessed, these instincts can accelerate leadership development by creating “bilingual physicians”—those who are fluent across both the clinical and business domains of healthcare leadership.

An example of how clinical training can be a double-edged sword is “primum non nocere,” or “first, do no harm,” which is fundamental to the physician ethos and vital to safe and effective patient care. But applying this same risk aversion to business contexts can be restrictive. Strategy, at its core, involves risk-taking and bold decision-making. Physicians who can untether themselves from a default risk-averse mindset have great potential for professional progress versus peers. As one physician CEO recounted, he had to shift his mindset from “being right 99 percent of the time to being right 75 percent of the time,” and once he did, his clinical experience of making decisions under uncertainty proved to be a strength.

The duality of clinical training is also highlighted by the implications of a deeply ingrained hierarchy. While top-down authority can be essential in life-or-death moments, in other scenarios it can impede physicians from challenging the status quo, innovating, and taking ownership to solve problems. When physicians adhere to strict hierarchy and don’t speak up, their valuable strengths, such as curiosity, problem-solving, and a penchant and aptitude for lifelong learning, often go unrecognized. Unlearning this hierarchy allows them to showcase these qualities, which many CEOs see as physician superpowers that ease the path to the top job.

These strengths and other instincts shaped by clinical training can become differentiators at the executive level when deliberately retooled. For example, a physician leader trained as an intensivist explained how he was responsible for ICU patients with multiple, often simultaneously critical conditions, each competing for clinical priority and requiring input from specialists across the care team. His role wasn’t to be an expert in every condition but to interpret recommendations, weigh trade-offs, and make timely decisions. As CEO he relies on this ability to empower his team to lead, while he zeroes in on the issues that demand his unique ability to calibrate across the enterprise.

Clinical training gives physicians the potential to be bilingual leaders and achieve both mission and margin aspirations as CEOs. This is particularly important now considering the sector has reached a moment in which complex clinical change management, care model transformation, and patient-centric, personalized medicine will be differentiators for enterprises across the healthcare value chain.

Our conversations with current physician CEOs highlight the mindsets, behaviors, and experiences that shaped their career paths. These stories point to a broader truth: Unlocking the next generation of physician CEOs will require both individual transformation and institutional commitment.

While the path to CEO is not explicitly articulated in a playbook and is not as simple as ticking through a checklist, we postulate that there is a unique set of inputs, namely mindsets and behaviors, that can inform the journey to build the skills, knowledge, and experiences that result in distinct leadership profiles. Below, we share two examples of physician journeys to CEO: one in which clinical experience itself was the source of leadership development, and another in which early exposure outside the clinical realm was the building block.

One physician identified an opportunity to pioneer new surgical techniques to improve patient care. To do so, he collaborated with like-minded physicians beyond his institution to build external momentum and ultimately established and scaled a new clinical subspecialty. This propelled him early in his career into clinical leadership roles within his institution, and successful leadership behaviors ultimately led to the CEO role. Another physician CEO stepped fully outside the clinical domain. He initially tested the waters via a business internship which led to an opportunity in government. This broader experience opened doors to private health insurance companies, health tech, and investing. Along the way, he deepened his functional understanding of strategy, policy, and finance through direct experience.

For each of these CEOs, their unique mindsets shaped their behaviors, journeys, and leadership profiles. In both pathways, the CEOs remained grounded in care delivery while demonstrating their ability to bridge the clinical and corporate worlds. They exhibited a great appetite for lifelong learning, which helped sharpen their leadership edge, and they believed in their capacity to adapt to new situations. For the clinical leader, just as critical to his success was how he learned from others. For example, he didn’t simply passively inherit mentors but instead actively cultivated them and evolved his group of mentors as new challenges arose. For the CEO who ventured beyond the clinical path, he took career-defining risks early and often, saying yes to roles others might decline in favor of a safer bet. Rather than climb a single ladder, he moved laterally and diagonally across sectors and functions, assembling diverse experiences that expanded his potential.

For aspiring physician leaders, the path to success lies in the pursuit of achieving patient impact at scale and not simply in attaining the CEO title. Understanding current CEOs’ journeys offers a road map to increase their likelihood of reaching the top role. It begins with an honest, intentional assessment of their own strengths and gaps in comparison to the behaviors and mindsets of excellent CEOs. To identify blind spots and perception issues, they should seek out candid feedback from both champions and skeptics. The goal: to identify their endowed strengths—natural abilities that can become signature assets, or superpowers, as CEOs—while recognizing areas they should continue to evolve through deliberate focus.

Historically, while many healthcare institutions have elevated physicians to clinical leadership positions such as chief medical officer or chief physician executive, they typically have not considered these roles as part of the CEO succession pipeline. At times, these roles may be seen as symbolic rather than having purview over the institution’s value drivers. However, our interviews suggest that a growing number of boards and executives are recognizing physicians’ CEO ambitions and intentionally considering pathways to support their transition from clinical practice to enterprise-wide leadership.

To accelerate this shifting paradigm, healthcare organizations can take an active role in building physician “leadership factories”—intentional, well-resourced systems that identify, develop, and elevate talent from within through structured, longitudinal pathways that proactively cultivate leadership. A critical first step is clearly defining what enterprise leadership looks like for physicians, including the foundational mindsets and behaviors that shape them. When organizations help physicians adopt these mindsets early, they catalyze the development of new skills, knowledge, and experiences, enabling leadership journeys that pave new pathways to the CEO role.

Ultimately, a leadership factory isn’t simply about preparing someone for a specific role or filling a vacancy. It’s about building a system that continually produces a deep bench of adaptable, enterprise-ready leaders who can step into a wide range of roles and are able to meet the evolving complexities of healthcare.

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For many physicians, enterprise leadership represents an opportunity to scale their impact, from improving care one patient at a time to influencing care for entire populations. Realizing this vision requires more than ambition; it demands a clear, deliberate path. By examining the journeys of successful CEOs, we believe we can help physicians thrive as leaders.