Abstract
Objective: Among all major sectors, healthcare has one of the highest proportions of chief executive officers (CEOs) with doctoral degrees. Despite this, the relationship between doctoral attainment and hospital organizational performance remains poorly understood, leaving hospital boards and healthcare executive search firms without a sufficiently developed empirical basis for evaluating this distinct executive educational credential. Unlike prior studies comparing physician and nonphysician CEOs, this study examined associations between hospital CEO doctoral attainment and organizational performance in 509 U.S. acute-care hospitals across nine states.
Methods: This cross-sectional observational study merged data from the American Hospital Association (AHA) Annual Survey, Area Health Resources Files, Medicare Cost Reports, Leapfrog Hospital Safety Grades database, and Centers for Medicare & Medicaid Services (CMS) Hospital Compare database. CEO tenure (2016–2019) was obtained from the AHA Annual Survey, and doctoral attainment was identified from executive biographies, publicly available professional profiles and hospital websites. Organizational performance was assessed using Leapfrog Hospital Safety Grades database, CMS Overall Hospital Quality Star Ratings, and operating margin. Binary logistic regression and ordinary least squares (OLS) regression were used to examine associations while adjusting for hospital and market characteristics.
Results: Compared with hospitals led by CEOs without a doctoral degree, those led by CEOs with a doctoral degree had higher odds of earning an A or B Leapfrog Hospital Safety Grade (OR = 1.87; p = .041) but, on average, lower operating margins (β = –0.39; p = .002). No significant association was observed with CMS Overall Hospital Quality Star Ratings.
Conclusions: Hospital CEO doctoral attainment demonstrated differing associations across widely recognized dimensions of hospital performance: patient safety, quality, and operating margin. These findings reframe doctoral attainment within the U.S. healthcare sector as a potentially consequential executive characteristic. This study provides an empirical basis for further research and a more evidence-informed approach to evaluating doctoral attainment for hospital boards and healthcare executive search firms.