How Surgeons Can Build Key Leadership Skills to Extend Their Influence across Health Systems

As health systems become increasingly complex and interconnected, surgeons have more opportunities than ever before to step into leadership roles within their organizations. Their work often spans multiple departments, as well as a variety of settings and clinical teams, giving them insight into how decisions made in one area can affect the broader system.

“Surgeons bring a valuable perspective shaped by years of working across many parts of the health care environment,” explains Ali Tavakkoli, MD, chief of the Division of General and GI Surgery at Mass General Brigham, Francis D. Moore Professor of Surgery at Harvard Medical School, and co-director of Harvard Medical School’s Surgical Leadership certificate program. “They have a front-row view of how care is delivered, when and where challenges arise, how best to address them, and what it takes to keep teams working effectively under pressure.”

This broad perspective can position surgeons to contribute not only to patient care, but also to initiatives that shape operations, strategy, quality improvement, and organizational change across health systems.

Yet, despite this vantage point, many surgeons can feel out of their element when they move beyond direct patient care into broader organizational responsibilities. While leadership roles draw on many of the same qualities that make surgeons effective in the operating room, they also require skills that are not typically taught during surgical training.

Traditional surgical education focuses on clinical mastery and technical expertise, but it does not usually address the deeper administrative and strategic capabilities needed to lead at the system level.

Skills That Strengthen System-Level Leadership

For surgeons interested in leading divisions, departments, projects, or system-wide initiatives, Tavakkoli points out several key areas where they should develop their skills to strengthen their effectiveness.

1. Negotiation: While negotiation in clinical settings tends to focus on patient care, surgeons may find that negotiating outside the operating room requires a much deeper understanding of competing perspectives, as well as the ability to build consensus and ensure that stakeholders feel heard. It also requires patience, experience advocating for limited resources, and the ability to guide conversations among departments with different priorities.
2. Communication across Diverse Audiences: Communication in the operating room is concise and task driven, while leadership communication requires a different approach. Effective leaders must anticipate how messages will be received and know how to create space for dialogue. They must understand the basics of different business areas, such as finance, technology, staffing, and outpatient care, and adjust their tone and pacing to find common ground among colleagues with different perspectives and priorities. These skills, which are rarely emphasized in surgical training, are essential for guiding teams and influencing decisions across a complex system.
3. Financial Stewardship: While surgeons may have experience managing budgets within their own teams, broader leadership roles require a deeper understanding of resource allocation, long-term financial planning, and how investment decisions can influence patient outcomes. Leaders need to understand not only how resources are allocated, but also how financial decisions support organizational goals while maintaining a focus on patient care. Surgeons who develop this literacy are better prepared to advocate for their teams and make decisions that support institutional priorities.
4. Developing and Leading High-Performance Teams: Building a successful surgical team requires coordination, trust, and a shared commitment to excellent outcomes. Leadership at the departmental or system level builds on those same principles but extends them across larger and more diverse groups. Effective leaders create a culture where expectations are clear, team members feel empowered to contribute, and individuals have the resources and training to succeed while aligning the team around common goals. They know how to bring together people with different expertise to solve complex problems—and when to step back and let others lead.

How Surgeons Can Build These Capabilities Intentionally

While building these skills may sound like a tall order, Tavakkoli says there are many structured learning opportunities that can help surgeons deepen their expertise in these areas. Some surgeons pursue mentorship from local leaders who can help them interpret institutional dynamics and refine their leadership style, while others prefer structured leadership programs that allow surgeons to learn new skills in a group setting.

Tavakkoli sees value in both approaches. “What matters,” he says, “is finding an environment that helps surgeons strengthen leadership capabilities they may not have had the opportunity to develop during clinical training.”

For the latter approach, he stresses that it’s essential to select leadership programs geared specifically to surgeons, since they build on strengths that participants already possess while providing opportunities to learn from peers and instructors. Programs designed for surgeons also tend to address the leadership challenges that participants are likely to encounter in their day-to-day work.

Rather than presenting leadership concepts in the abstract, the most effective programs provide the opportunity for surgeons to examine real-world scenarios involving clinical operations, workforce management, quality improvement, and organizational change. That context can make it easier to apply new skills immediately.

In addition, learning alongside peers who are facing similar challenges can create valuable opportunities for surgeons to exchange ideas and learn from others’ experiences. Participants often gain practical insights into how colleagues have approached common leadership challenges, from workforce management to building consensus across departments.

Choosing the Right Leadership Training

“The most effective learning environments for surgeons will cover the full spectrum of leadership competencies,” Tavakkoli says. This includes understanding how leaders negotiate, communicate across diverse audiences, build and lead high-performing teams, promote innovation, and guide quality and safety efforts. He also recommends that surgeons learn about innovation management and academic leadership to better understand how decisions are made and implemented across complex systems.

“Surgeons can greatly benefit from content that reflects the realities of modern health systems and prepares them to understand how decisions are made and how leaders can most effectively guide change,” he says.

Tavakkoli also advises surgeons to look for learning options that fit within their demanding clinical schedules so they can continue to work while participating. When surgeons use a negotiation strategy during a departmental discussion or a new communication approach in a multidisciplinary meeting, they are applying practical concepts in real time while preparing for future leadership opportunities.

“Surgeons who invest in continuous learning are better prepared to adapt to new challenges and grow into leadership roles that will help shape the direction of their institutions,” he adds.