This article explores factors that influence decision-making by physician leaders, particularly at the executive level. Most physician leaders maintain their clinical practices and some may also have active academic careers, resulting in multiple accountabilities. Managing these accountabilities requires expenditure of time and energy. Other members of the executive team may also bear multiple accountabilities, but physicians are unique in the complexity of their work environment. This article is not intended to be an academic treatise but rather a summary of experiences observed and lived by the author over 25 years as a physician leader.
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