Championing Physician Leadership Development: AAPL's Five-Decade Commitment Meets Healthcare's Critical Moment

The recent NEJM Catalyst discussion article by Chris DeRienzo, MD, MPP, and Elisa Arespacochaga, MBA,(1) represents an important moment in healthcare leadership discourse. Their article describes the American Health Association (AHA) framework for developing physician leaders in hospitals and health systems, which addresses what many have long recognized but few have systematically codified: the urgent need for intentional, structured pathways to transform excellent clinicians into effective executive leaders.

At the American Association for Physician Leadership (AAPL), we applaud this contribution to the field and recognize the American Hospital Association's appreciation that physician leadership development can no longer be left to chance or serendipity.

Having initially invented the concept of physician leadership, AAPL has been dedicated to precisely this mission for more than 50 years. Our association was founded on the conviction that physician leadership is not merely desirable but essential for healthcare transformation, and that leadership excellence requires skills beyond those taught in medical school and residency.

The NEJM Catalyst authors’ framework validates what we have championed throughout our history: that closing the knowledge, exposure, and experience gaps requires systematic investment, institutional commitment, and a fundamental reimagining of how physicians prepare for executive roles.

The AHA framework's articulation of "version 3.0" physician leaders resonates deeply with AAPL's current strategic direction and its own competency framework, which has been validated over 15 years. Today's chief physicians must indeed be bilingual — fluent in both clinical medicine and executive leadership — capable of speaking authentically to physicians while engaging strategically with CEOs, CFOs, and boards. They must understand EBITDA as thoroughly as they understand clinical quality measures. They must navigate value-based contracts, lead virtual teams, implement AI-driven decision support, and manage physician enterprise relationships across increasingly complex organizational structures.

This is precisely the reality AAPL has been preparing physician leaders to face. Recognition by the AHA now, in this time of healthcare transformation, is an important step forward for the industry.

What particularly excites us about the NEJM Catalyst article is its emphasis on intentionality. The authors quote a chief physician lamenting that "we more or less just throw [emerging physician leaders] into the fire," and another describing their path as "circuitous" rather than following a clear ladder. These testimonies underscore why AAPL's work has never been more critical. For five decades, we have been building that ladder — or more accurately, constructing multiple pathways — recognizing that physician leadership development requires diverse approaches tailored to individual career trajectories and organizational contexts.

The AHA framework's identification of five core domains — finance, strategy, people management, operations, and quality/safety/medical staff — aligns remarkably with AAPL's educational architecture and existing competency framework. Our curriculum has long addressed these competency areas through comprehensive certification programs, targeted courses, and practical learning experiences. However, we recognize that traditional models requiring years of study for single comprehensive credentials no longer serve the dynamic needs of today's healthcare environment. This is why AAPL's own transformation as a professional association is so timely and significant.

At our 2025 Fall Leadership Institute in Scottsdale, AAPL President and CEO Peter Angood, MD, unveiled several initiatives designed specifically to address the challenges identified in the AHA framework. Our new portfolio of AAPL Micro-Credentials represents an evolution beyond traditional certification models, allowing physicians to assemble personalized competency portfolios matching their specific career trajectories. Whether a physician needs expertise in leading virtual teams, navigating value-based contracts, or implementing AI-driven decision support, AAPL now offers targeted credentials that close specific knowledge gaps without requiring years away from practice.

Our AAPL Accelerators take this further by providing adaptive learning platforms that customize educational pathways based on individual knowledge gaps, learning preferences, and career goals. This assessment-driven approach ensures physician leaders receive precisely the education they need when they need it — directly addressing the framework's emphasis on moving beyond one-size-fits-all programs.

The AHA model emphasizes that acquiring knowledge alone is insufficient; physicians must gain exposure and experience. AAPL's expanded Communities of Practice and AAPL Vanguard Group create exactly these opportunities, providing a sense of psychological safety where physician leaders discuss sensitive topics and real-world challenges without fear of professional consequences.

The framework's discussion of emotional intelligence and relational leadership skills particularly resonates with AAPL's holistic approach. The authors note that physicians must "learn to shift from individual responsibility for clinical decision-making to making group decisions as part of a leadership team." This transformation requires more than technical knowledge — it demands fundamental shifts in mindset, communication patterns, and professional identity.

AAPL's mentorship programs, peer consulting networks, and member-led educational sessions facilitate exactly these developmental experiences, transforming passive learners into active contributors and helping physicians make the leap from "command and control to being part of a leadership team."

Looking toward the future, AAPL's investment in AI-enhanced learning and generative AI-based discussion boards represents our commitment to leveraging cutting-edge technology for leadership development. These tools will help participants learn in real time the dynamics of group discussions while receiving feedback on their individual participation — creating dramatically more robust learning experiences. This aligns perfectly with the AHA framework's emphasis on gaining exposure to real-world leadership situations and developing competencies through direct experience.

The framework's attention to the isolation and loneliness of physician leadership roles also mirrors AAPL's longstanding recognition that chief physicians need peer communities. As one of the interviewed leaders notes, it's crucial to "maintain contact with others who understand my problems and get the jokes without me having to explain them."

AAPL's global community — spanning dozens of countries with website traffic from 120-150 countries monthly — provides exactly this network. Our partnerships with Canadian, European, Australasian, African, and Indian healthcare systems reflect our understanding that healthcare challenges transcend national boundaries and that physician leaders benefit from cross-border learning and collaboration.

The NEJM Catalyst commentary emphasizes that healthcare needs have never been greater, while membership in professional organizations has plateaued or declined. AAPL's response is to position ourselves as an indispensable partner in this era of transformation by delivering unprecedented value through technology-enabled learning, personalized development pathways, and authentic community. Our AAPL Helix technology platform, which features a new learning management system, refreshed mobile app, updated website, and contemporary e-commerce capabilities, ensures that user experience drives every interaction with our offerings.

Perhaps most importantly, both the AHA framework and AAPL's vision share a fundamental conviction: Physician leadership is learned, not innate. While physicians bring clinical expertise and commitment to patient care, executive leadership competencies require intentional development through structured learning, meaningful exposure, and direct experience with accountability. The days when physician leaders could rely solely on serendipity or happenstance must end. Healthcare's complexity and the stakes for patients demand better.

As we reflect on AAPL's 50-year legacy while embracing innovation, we see the NEJM Catalyst article’s description of the AHA framework as both validation and inspiration. It validates our decades of work building information resources, educational programs, credentials, and communities that develop physician leaders. It inspires us to continue evolving our offerings to meet healthcare's changing needs. The framework's call for hospitals and health systems to create intentional physician leadership development programs opens doors for deeper partnerships between AAPL and healthcare organizations nationwide. In fact, AAPL already delivers over 400 such programs annually and continues to expand in this regard.

Angood's vision that AAPL trains all physicians to lead from within, rooted in care for others, successfully awakening the opportunity for visionary stewards of medicine to emerge from across all disciplines and backgrounds, complements the AHA framework's practical approach to competency development. Together, these perspectives chart a path forward where physician leadership development becomes systematic, accessible, and aligned with healthcare's most pressing needs.

We are pleased that the NEJM Catalyst authors and AHA recognize physician leadership development as worthy of scholarly attention and practical framework development. This visibility elevates the conversation and encourages more healthcare organizations to invest in intentional leadership development programs.

AAPL stands ready as a partner in this essential work, bringing five decades of expertise, a global community of physician leaders, and innovative educational offerings designed for today's complex healthcare environment.

The question is no longer whether physicians need leadership development, but how quickly can we scale proven approaches to meet the field's urgent needs. AAPL remains committed to ensuring that every physician who aspires to leadership — regardless of discipline, geography, or career stage — has access to the knowledge, exposure, and experience necessary to succeed. Because when physicians lead from within, healthcare systems become more humane, effective, and resilient. That transformation is not just leadership — it's our collective calling.

Reference

1. DeRienzo C, Arespacochaga E. A Framework for Developing Physician Leaders in Hospitals and Health Systems, from Conversations with Physician Executives. NEJM Catalyst. 2025;6(11). https://doi.org/10.1056/cat.25.0005 .