Lessons of experience: Key events and lessons learned of effective chief medical officers at freestanding children's hospitals.

As the healthcare environment changes, physician executives who are effective leaders and agents of change are needed. Healthcare organizations that are successful at developing effective physician leaders will be at an advantage. This article examines how physician leaders develop on the job. Such knowledge and insight can be useful to healthcare systems looking to develop a new physician leadership development program or improve an existing one. This study identified that learning from other people (e.g., mentors, role models, bosses) and key events involving hardships are valuable means in developing leadership acumen for chief medical officers (CMOs) at freestanding children's hospitals. Most of the hardships CMOs reported were a result of mistakes made when they were trying to institute change. CMOs reported a disproportionately low number of learning events from developmental job assignments. This finding may indicate a lost opportunity on the part of healthcare organizations in developing leaders. The most frequent lessons learned pertained to handling relationships, interpersonal skills, and executive temperament. Skills in handling relationships and interpersonal skills were best learned through business mistakes made in dealing with others. Lessons in executive temperament, self confidence, and handling adversity were most often learned from role models and bosses. These findings indicate that physician leadership development initiatives should intentionally and systematically incorporate job assignments, role models, and mentors.