Healthcare is under extraordinary financial, operational, and cultural pressure. The leadership decisions made in the next few years will define what care looks like for decades. That’s why this Leadership Rounds conversation between Dr. Reena Pande and McKinsey Partner + practicing emergency physician Laura Medford-Davis, MD lands with such urgency: it addresses a leadership gap hiding in plain sight.
Nearly 60% of U.S. physician leaders say they’re interested in becoming CEOs, yet only about 15% of healthcare CEOs have clinical backgrounds.
So what’s the issue? It’s not just in the pipeline. It’s a structural mismatch between what organizations say they want (clinical credibility, trust, mission alignment) and how they define executive readiness.
Laura describes a familiar early-career inflection point: the moment when clinical training reveals the system underneath medicine. During her third-year rotations, she realized that even exceptional physicians often couldn’t overcome systemic barriers that prevent patients from receiving the right care at the right time… and prevent clinicians from doing their best work.
That recognition drove her to pursue system-level impact across multiple levers: health services research, federal policy, and eventually, operational strategy.
Laura’s story includes a critical insight for clinician leaders. Impact isn’t only about evidence. It’s about where decisions are made.
She describes the frustration of generating research that didn’t translate into operational change, then moving into policy and seeing how frequently decisions were shaped by limited stakeholder input and political realities. But her takeaway wasn’t cynicism, it was clarity: to change care, you often need proximity to leadership decisions and implementation.
Laura joined McKinsey, thinking she’d build business fluency and then likely move into health system leadership. Instead, she found she loved the work, especially partnering with care delivery leaders who were ready to operationalize change. Today, she leads physician-focused work and co-leads clinical operations at McKinsey, including physician-insights surveys that track clinicians' experiences with the system.
One of the most important ideas in the episode is what Laura and Reena call a vicious cycle:
McKinsey reporting has described this as an unintentional “cycle of exclusion,” where physicians seen as unready are overlooked for development opportunities.
This matters because the gap is not purely about skill. It’s also about access, sponsorship, and institutional design.
Laura offers a framing that should be required reading for every board and search committee: clinical training is a double-edged sword.
Yes, physicians often have real gaps in finance, M&A, and operating cadence. But clinical training also develops rare leadership strengths:
Her point isn’t that clinical training automatically creates CEOs. It’s that it creates a foundation that can be translated, if institutions help clinicians build the missing muscles.
A particularly actionable moment in the conversation is Laura’s explanation of how clinicians can reframe decision pressure in business settings.
In clinical contexts, decisions often feel irreversible. In business settings, most decisions are “two-way doors” — iterative and revisable — rather than “one-way doors” that permanently close options. This mindset shift helps clinician leaders increase velocity without sacrificing rigor.
Laura argues that the answer lies in both individual and institutional factors.
Clinicians who successfully reach CEO seats do so with purposeful skill development, treating leadership as its own discipline. Some use formal coursework, while many seek mentorship, turn to apprenticeship-like exposure, and rely on deliberate practice. The common thread: they take ownership of the gaps and intentionally close them.
The bigger unlock is institutional design:
In the cap to the conversation, Reena asks the question every healthcare leader is asking: how does AI change this?
Laura’s answer is pragmatic: AI can help identify leadership signals through predictive analytics and broader performance patterns, but more importantly, physician leaders are essential for setting guardrails and governance as AI reshapes care. Clinicians understand risk, workflow reality, and what “safe” means in practice.
Laura ends on a hopeful note: the 60% interest signal surprised even her team. That interest represents a truly meaningful bench if the industry builds the support to harness it.
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Laura Medford-Davis, MD, MS is a Partner at McKinsey & Company and a board-certified, practicing emergency physician. At McKinsey, she leads physician-focused work and co-leads clinical operations within the firm’s provider performance work, including McKinsey’s physician insights research and surveys.
An alumn of the University of Pennsylvania, Harvard Medical School, and the University of Oklahoma, her career has focused on improving how care is delivered and experienced: strengthening clinical operations, culture, and performance so that health systems can expand access while improving the day-to-day experience for frontline clinicians.
Laura has also contributed to McKinsey’s research and writing on physician workforce dynamics and physician leadership, including work on the emerging physician CEO pipeline and the pressures facing healthcare organizations today.
