Physician executive leadership can be hard to sustain because of the unique and complex intersection of personal, professional, and organizational challenges. These challenges include:
Dual role demands (clinical and administrative).
Emotional and cognitive fatigue.
Cultural and structural resistance.
Lack of formal training and mentorship.
Misaligned values.
Work-life imbalance and burnout.
Career longevity.
Sustaining a leadership career over decades requires resilience strategies, intentional support systems, and a redefinition of success. Critical success factors include a clear personal purpose and boundaries, organizational support and recognition, leadership development and mentorship, and finally, regular realignment of role with core values.
Physician leadership is a path marked not only by achievement, but also by resilience, adaptability, and continuous growth. While traditional leadership styles such as transactional and laissez-faire leadership focus on compliance and autonomy, physician leaders embody transformational qualities that adapt to the evolving landscape of healthcare (including artificial or augmented intelligence), emphasizing collaboration, community engagement, and value-driven outcomes. Additionally, the rapid rise in burnout in clinicians and leaders alike requires increased focus on sustainability.
What Does It Mean to Be Sustainable?
To “sustain” is to maintain, support, uphold, or endure — especially over time. When we apply that to a career, particularly in leadership, sustainability takes on a deep, personal meaning. A sustainable leadership career endures through the evolving demands of healthcare, the pressures of performance, and the complexity of human relationships. It allows us not only to persist, but also to thrive, staying aligned with our values and our sense of purpose. It begins and persists with growth in three key domains: self-awareness, other-awareness, and situational awareness.
Leadership Is a Skill Set — Not a Trait
Leadership is often misunderstood as an innate trait, something one is born with. However, research and experience demonstrate that leadership is actually a set of skills — learnable, expandable, and improvable. Carol Dweck’s Growth Mindset model offers a psychological framework grounded in the belief that abilities and intelligence can be developed through effort, learning, and persistence.(1)
This belief has powerful implications for physician leaders and their teams. In the workplace, it fosters a culture of continuous learning, innovation, and leadership development. For the individual leader, it supports personal growth by building resilience and adaptability in the face of challenges. Ultimately, Dweck’s model underscores that our beliefs about our potential profoundly shape our success — and that adopting a growth mindset can unlock untapped capabilities.
Here are eight essential leadership skills that provide a solid foundation.(2) Each can be developed over time and can contribute to leadership sustainability:
Curiosity. Great leaders are driven by a desire to understand more. They ask thoughtful questions, challenge assumptions, and think broadly and ambitiously. Curiosity fuels learning, exploration, and innovation — qualities that keep leaders open to new ideas and emerging trends in healthcare and beyond.
Authenticity. Authentic leaders are deeply self-aware. They recognize their strengths and acknowledge their limitations without pretense. They lead with integrity, consistently aligning their actions with their values and core identity. This builds credibility and trust with colleagues and teams.
Analytical Thinking. Effective leadership requires the ability to navigate complexity. Analytical thinking involves breaking down problems, identifying patterns, understanding root causes, and formulating evidence-based solutions. Leaders who master this skill can make sound decisions in fast-paced, data-driven environments.
Adaptability. Healthcare is dynamic and ever-changing. Leaders must remain agile and thrive in uncertainty. Building adaptability involves stepping outside your comfort zone, embracing change, and remaining effective even when conditions are unpredictable. It is about being both responsive and resilient.
Creativity. Leadership does not mean having all the answers — it means cultivating a climate where innovation can take root. Creative leaders encourage experimentation, welcome diverse ideas, and support calculated risk-taking, all of which are vital for solving complex organizational challenges.
Comfort with Ambiguity. Leaders regularly face incomplete information, competing demands, and uncertain outcomes. Developing comfort with ambiguity means being able to move forward without having all the answers. Asking reflective questions like “What if?” and “So what?” helps reframe problems and generate new insights.
Resilience. Setbacks and failures are part of every leadership journey. Resilient leaders do not just bounce back; they learn, adapt, and continue moving forward. They model perseverance, demonstrate emotional strength, and foster a culture that sees challenges as opportunities for growth.
Empathy. Emotional intelligence is not optional; it is fundamental. Empathetic leaders understand and connect with others’ perspectives. They listen actively, communicate compassionately, and create environments where people feel seen, heard, and valued. Empathy strengthens trust, collaboration, and team well-being.
Effective Communication in Leadership
Effective communication is a foundational skill for leadership, particularly for emerging leaders navigating today’s complex, fast-paced, and often ambiguous environments.(3) For physician leaders, poor communication can lead to unnecessary stress, misaligned efforts, and ultimately, burnout. A leader who is misunderstood may struggle to achieve sustainable success or build high-functioning teams.
To communicate with clarity and impact, consider developing the following skillsets:
Active Listening. Strong leaders listen with intention. Active listening means giving full attention, asking thoughtful questions, and demonstrating genuine interest in team members’ perspectives. It not only improves understanding, but also builds trust and conveys respect and empathy.
Clear and Concise Messaging. Communicating with precision is essential. Leaders should convey their messages in a straightforward, unambiguous manner to reduce confusion and ensure key information is understood and retained.
Adaptability in Communication Styles. Effective communication is not one-size-fits-all. Different audiences, situations, and contexts require different approaches. Skilled leaders adjust their tone, language, and delivery to suit the needs of the moment, whether addressing a large group, managing conflict, or guiding an individual.
Feedback Mechanisms. Communication must be two-way. Creating regular opportunities for feedback — through one-on-one meetings, performance reviews, or anonymous input — encourages dialogue, strengthens relationships, and helps surface issues early.
By mastering these essential communication skills, emerging leaders can significantly improve their influence, foster stronger team engagement, and drive better organizational outcomes. In today’s healthcare environment, the ability to communicate with clarity, empathy, and adaptability is not just a leadership asset — it is a necessity.
A Note to Late-Career Physician Leaders
A recently published series of articles titled “Fostering Physician Well-being Over the Career Lifecycle” offers further valuable insights on sustainability and professional fulfillment.(4-7) Physician leaders will find insights from experts in the field in each season of their careers (trainees, early career, mid-career, late career, and in retirement).
Senior physician executive leaders are often in the “late-career” category. Leaders at that stage can reflect that their professional journey, much like life itself, is marked by a series of meaningful experiences — interactions, discoveries, relationships, milestones, challenges, and opportunities.(7) This late stage can be especially fulfilling, offering opportunities for deep impact, reflection, and preparation for the future. During this period, physician leaders bring a wealth of knowledge and insight that can greatly benefit patients, teams, and the broader medical community.
It becomes increasingly important to consider how best to pass the torch — through mentoring, nurturing future leaders, and contributing to professional development. Some may choose to collaborate with their institution on legacy projects that align with their passions and values.
As retirement approaches, thoughtful planning beyond finances — including emotional well-being, social networks, and meaningful activities — can pave the way for a more satisfying and purposeful transition. Cultivating these relationships and interests early in the final phase of one’s career can ease the shift into retirement and enhance life after the C-suite. Sustainable leadership is not a solo pursuit. It is a shared journey — one that requires us to invest in ourselves, support one another, and remain grounded in purpose.
References
Dweck CS. Mindset: The New Psychology of Success. Random House; 2006.
Knight R. 8 Essential Qualities of Successful Leaders. Harv Bus Rev. December 13, 2023. Accessed June 6, 2025: https://hbr.org/2023/12/8-essential-qualities-of-successful-leaders .
Fortin MD, Frey KA. Essential Communication Skills for Emerging Leaders. In: Pfeffermann N, ed. New Leadership Communication: Inspire Your Horizon. Springer; 2023:65-75. https://doi.org/10.1007/978-3-031-34314-8_5 .
Thomas LR, Brigham T, Shanafelt T. Residency and Fellowship: Fostering Physician Well-Being over the Career Lifecycle. Mayo Clin Proc. 2025; 100(9): 1649–1659. https://doi.org/10.1016/j.mayocp.2025.05.024 .
Rotenstein L, Harry E, Shanafelt T. The Early-Career Phase: Fostering Physician Well-being Over the Career Life Cycle. Mayo Clin Proc. 2025; 100(10): 1836–1845. https://doi.org/10.1016/j.mayocp.2025.05.025
Ligibel JA, Awad K, Shanafelt T. Mid-Career: Fostering Physician Well-being Over the Career Life Cycle. Mayo Clin Proc. September 2025. Epub ahead of print. https://doi.org/10.1016/j.mayocp.2025.05.026 .
Frey K, Arata M, Shanafelt T. Late Career: Fostering Physician Well-Being over the Career Lifecycle. Mayo Clin Proc. 2025;100(12):2255-2261. https://doi.org/10.1016/j.mayocp.2025.05.028 .