The job nobody wants anymore

Every January I take a week and go back through all the searches from the year before, the ones that filled and the ones that didn't, just looking for patterns. The pattern that keeps showing up isn't about money. The roles that filled were the flexible ones, the ones somebody had actually thought about. The ones that sat open were the traditional 1990s clinical roles that offered nothing beyond patient volume, right? Same market, same posting sites, same compensation range. Different result.

So I've been reading Becker's coverage of the physician leadership pipeline, and it's interesting because it says out loud what a lot of us have been watching happen search by search.

Leaders across the country are reporting the same thing — physicians are turning down non-clinical roles. Dr. Sean Reinhardt at Penn Medicine Doylestown said most younger physicians are uninterested in anything "that seems more like administration." Dr. Nariman Heshmati at Lee Physician Group described "a separation between their passion for healthcare and their desire for work-life balance." And Dr. Michael White at Valleywise Health put his finger on the actual mechanism:

"If you're going to commit to something and do it well, you need dedicated time to focus on it."

Dedicated time. That's the whole thing.

Meanwhile the other end of the pipe is emptying out. Becker's ran a list two weeks ago of eight CMO and CNO exits so far this year, and most of them are retirements — people with 25 and 30 years in, walking out the door with all of it still in their heads. Their May piece put the physician shortage at somewhere between 13,500 and 86,000 by 2036, and noted that raising the average retirement age by just two years would close about 40,000 of that gap.

And demand is moving the opposite direction. The C-suite forecasts have more clinicians stepping into CEO and COO seats, and leaner teams built on hybrid roles — CNO/COO, that kind of thing — particularly in smaller hospitals. Which is where I spend most of my time. Under 200 beds, one leadership hire moves the whole system.

So: fewer people willing, fewer people left, more seats to fill. That isn't a recruiting problem. You can't source your way out of it.

My honest read

It isn't that physicians don't want to lead. It's that we ask them to lead on top of a full clinical load, with no protected time, often for less than they'd earn clinically, and with no training in how to actually do the job — and then we're surprised when they say no thanks, or when they say yes and drift back to clinical work eighteen months later.

About fifteen years ago I took a project for a year and I was unhappy the entire time while genuinely believing I was doing great work. The 360 came back and it was basically: Kevin knows what needs to be done, he's got the competence and the relationships — but Kevin's not happy, and he's bringing unhappy Kevin to work every day. Nobody had set me up for that role either. I just didn't have the language for it yet.

Three things I'd actually do, and none of them are expensive

Put the protected time in the job description before you post it. Not "as needed." A number. If you can't fund the number, you haven't funded the role.

Name the successor before the resignation letter. Every one of those eight exits was foreseeable. Retirement is the most predictable event in workforce planning and we keep treating it like a surprise.

Put support around the person for their first six months, from somebody who doesn't report to them and has no stake in how it goes. Most clinical leaders have never been trained to lead — we hand them the org chart and wish them luck. It's why we build coaching into every placement, but you don't need a search firm to do this. You need to decide it matters.

Take care of the people that take care of us. Most of the rest follows from that.

Kevin

Sources

- Becker's Hospital Review, The shrinking physician leadership pipeline (June 2025) — https://www.beckershospitalreview.com/quality/hospital-physician-relationships/the-shrinking-physician-leadership-pipeline/

- Becker's Hospital Review, 8 health system, hospital CMO and CNO exits in 2026 (Aug. 14, 2026) — https://www.beckershospitalreview.com/hospital-executive-moves/8-health-system-hospital-cmo-and-cno-exits-in-2026/

- Becker's Hospital Review, How hospitals are fending off a retirement wave (May 22, 2026) — https://www.beckershospitalreview.com/workforce/how-hospitals-are-fending-off-a-retirement-wave/

- Becker's Hospital Review, Where hospital leadership is headed by 2030 (Dec. 22, 2025) — https://www.beckershospitalreview.com/hospital-management-administration/where-hospital-leadership-is-headed-by-2030/