Organizational leaders are grappling with how to steer their companies through uncertain markets, protect stakeholder interests, and, most importantly, protect the health and safety of their workforce.

Why Physician Executives Have Become a New Staple on Executive Teams – Part 1













With the ongoing COVID-19 pandemic, population and occupational health have risen to the forefront for everyone. Organizational leaders are grappling with how to steer their companies through uncertain markets, protect stakeholder interests, and, most importantly, protect the health and safety of their workforce.


As Archetype has navigated these uncertain waters, we have been fortunate to be able to rely on the advice and guidance of not only our Chief Medical Officer, Dr. Ajay Kohli, but also our ecosystem of healthcare leaders. Dr. Kohli has years of experience in both the legal and medical fields. He previously worked as a corporate transactional attorney with experience in private equity M&A deals. He completed his residency in emergency medicine at Emory University, and currently practices medicine at Duke University Health System.


I recently sat down, virtually, with Dr. Kohli and Dr. Ray Fabius, Co-Founder and President of HealthNEXT and former Global Medical Leader at General Electric. Dr. Fabius has spent the better part of two years researching benchmark employer, organizational, and governmental efforts on building a culture of health. We discussed the importance of companies having access to a physician executive and the impact of COVID-19.


Here is part 1 of that discussion:



What is the primary role of a physician executive in the corporate space?


Ray: The role of the physician executive, or what might also be known as a corporate medical leader or Chief Medical Officer, is to guide the strategic plan and actions of protecting and promoting a company’s most important asset, its people.


A physician executive treats an entire company as if they are one patient. For example, the sophistication that we’re starting to be able to garner on a population basis allows physician executives who are working with employers to say to the CEO that the covered lives in your company, the employees and their families, have a high incidence of hypertension. This is a reasonable example, because when you look at populations of workforces, you may see an incidence as high as 10 or even 15%. In some of the companies that I work with, 18% of their workforce actually has high blood pressure as an issue. In this case, it would make sense for you to treat this entire population with a specific program on high blood pressure.



I spent the vast majority of my career in the HR consulting space, including in the healthcare sector. And it would appear to me that 20 years ago when we were talking about a physician executive, it was very much a physician that happened to be an executive.


What I’m hearing now is that the role is evolving. Is this true? And if so, what do you think has been driving that evolution?


Ray: The role of a physician leader is now emerging as a specialty. Just like being an orthopedic surgeon or an emergency room specialist. And so even in orthopedics, most people know now that there are sub-specialists. There are people who are really great at just dealing with back problems versus knee problems. What we are finding, even in the world of physician executives, is that there are some that are terrifically talented in areas such as what we’re dealing with right now, pandemic response. Or others are particularly gifted in travel medicine. Still, others may be gifted in creating evidence-based benefit designs.


We are headed toward the global marketplace ultimately recognizing a physician executive as a specialist, let’s say of medical management. There are now specific programs at the graduate level, that can provide a Master’s of Medical Management. Or, you can become a certified physician executive, a CPE. We’re starting to actually see advanced degrees that can distinguish someone as a better than average candidate for this role. I would also point out that many universities across the globe are offering specific MBAs, medical MBAs.


What might this look like in a corporate setting? What is starting to evolve in my thinking and in the company that I lead, HealthNEXT, is having a panel of physician executives, not unlike a law firm would, and to give smaller companies the opportunity to have access to this panel on retainer. A specific medical leader would be their primary medical leader but they would still have access to other physician executives that may have particular areas of expertise.


And so the value that employers can get from this is predicated on the ability of the physician executive or physician executive team, being able to provide guidance across a huge array of domains, including the few that I’ve mentioned already.



During this time, a line I find myself repeating is from Vladimir Lenin. “There are decades where nothing happens; and there are weeks where decades happen.”


We’ve seen so many examples of the future being accelerated during COVID-19. As we look to the future, how do you see the role of a physician executive evolving as a result of the pandemic?


Ajay: The pandemic happened very suddenly. People are now more focused on healthcare, not just their own healthcare and their own health, but the health of the community at large. Because as we know, what one person may or may not do during this pandemic can affect other people. And that’s really huge. I think going forward, whether you’re a small company or a large company, corporate leaders are going to be more in tune to the general health of their employees. I think having a physician executive is going to be even more important going forward.


Ray: Initially, in any emergency situation, there is a good bit of chaos, and there’s not a lot of good information. As information started to become more clear around this particular infector, COVID-19, there were complications in interpreting the information for practical application to the workplace. Taking in the information as it comes through and interpreting it in a way that has practical applications for employers everywhere is a real challenge and an important part of the physician executive’s role.


The value that physician executives like myself and my colleagues, provide to employers is not only helping them determine what’s appropriate to shut down and what’s appropriate to keep going but how to manage essential workforces. Looking ahead, it’s asking how do you reopen your businesses? I will tell you that for sure the complexity of the decisions that will be required to reopen businesses will be much greater than the decisions that were required in terms of lockdown.



From your perspective, are there any major trends you’re noticing that will likely live past the pandemic?


Ajay: I think going forward, this pandemic has really highlighted the need for more telehealth services. We’re seeing a boom in that here at Duke and nationwide. I think having a telehealth service for any company managed by a physician executive is going to be key going forward. A lot of people are afraid. Do I go to the ER because I have a fever and a cough? Do I go to urgent care? Do I go to my primary care doctor? I think this is really going to underscore the need for more comprehensive telehealth services, which in the end, I think are going to save on medical costs for self-insured companies.


Ray: Telemedicine is something that a physician executive can help facilitate, even in terms of the benefit structure. So we’ve been advocating that the employer provide telemedicine services during COVID-19 without a co-pay, that they’re fully covered. And then we provide guidance as to the kinds of physicians that should be accessed with telemedicine.


I see a day where all primary care doctors actually have telemedicine services. And what a wonderful augmentation it will be for that relationship, when I can get on the computer with my doctor and discuss a problem that I have, just to determine whether I need to go to see them at the office, him or her at the office or head to an emergency room or access a specialist.


Stay tuned for part 2 of our discussion with Dr. Ajay Kohli and Dr. Ray Fabius on the evolution of occupational health. For additional resources from our ecosystem, take a look at the 7 Ways Archetype’s Ecosystem is Responding to COVID-19.