The Organizational Effects of Educational Background on Hospital Leadership: A Systematic Literature Review

Open Access
Mcmanemin, Lauren
Area of Honors:
Health Policy and Administration
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Jonathan Rogers Clark, Thesis Supervisor
  • Rhonda BeLue, Honors Advisor
  • Hospital
  • Health Care
  • Literature Review
  • Leadership
  • HPA
In 2013, the hospital CEO turnover rate in the United States reached the highest percentage seen in over 30 years. Researchers and the general public blame the lack of medical insight of current business leadership for the high turnover, and call for an increase in physician executives. In response to this demand for physician leadership, and the limited amount of current research on the subject, this systematic literature review analyzes whether the educational background (MD vs. MBA) of hospital leadership affects certain elements of the organization (quality, finance and employee engagement). The paper utilizes three management theories, (1) Upper Echelons Perspective, (2) Leadership Identity Theory and (3) Followership, as theoretical guides for interpretation and organization of the analysis. A large majority of the articles reviewed (18 out of 23) argue that physicians make better hospital executives. Only a limited set of articles support business executives, all within the employee engagement section of the analysis. Several studies partially or fully argue that the educational background of the leader has zero effect on hospital outcomes. In total, the majority of the findings within the theories and the reviewed articles support physician hospital executives. However, even though many perspectives are offered in the literature, very few authors conduct formal analyses to test their ideas. Additionally, a majority of the authors supporting physician executives recognize the need for management training before taking on such a role.