How to Give Clinicians Real Decision Rights in Healthcare

Healthcare organizations make countless decisions that shape how care is delivered: which technologies to adopt, how teams are staffed, how workflows are designed and where to invest for the future. Yet the people who work closest to patients are not always in the room when those decisions are being made.

That disconnect can be costly. A decision that looks sensible on a spreadsheet may create unexpected friction in a clinical setting. A technology selected to improve efficiency may complicate a workflow. A staffing strategy that works operationally may look very different from the perspective of the people responsible for delivering care.

The answer is not to put clinicians on every committee or require consensus on every decision. But simply asking for feedback after a plan is largely settled does not create genuine influence either. The challenge for healthcare leaders is finding the point between those extremes: How can clinicians have a meaningful voice in decisions that affect their work and their patients without creating another layer of bureaucracy?

Members of the Senior Executive Healthcare Think Tank bring perspectives shaped by experience in patient experience, workforce strategy, policy, quality, equity and healthcare technology. They weigh in on what meaningful clinician influence should look like—and how leaders can build it into decision-making without sacrificing the ability to move.

“Define which decisions require clinical input, involve the right frontline representatives early, and give them clear authority, timelines and access to relevant data.”

– Jordan Henry, Founder and Chief AI Ethicist at Veritas AI Consulting

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Make Clinician Participation Consequential

Jordan Henry, Founder and Chief AI Ethicist at Veritas AI Consulting, says leaders should resist the temptation to create broad committees simply to demonstrate that clinicians have been consulted.

“Leaders can give clinicians real influence by designing focused, decision-linked participation rather than adding broad committees,” he says. “Define which decisions require clinical input, involve the right frontline representatives early, and give them clear authority, timelines and access to relevant data.”

The distinction between being consulted and having actual decision rights is critical. Henry recommends mechanisms such as rotating clinician advisory panels, time-limited design sprints and embedded clinical leaders within operational and technology teams.

“Distinguish consultation from shared decision rights so expectations are explicit,” he says.

He also recommends making the influence visible after the decision is made. Organizations should document how clinician input changed a decision, explain when it did not and measure whether the resulting change improved workflow burden, patient safety, adoption or turnaround time.

“This builds trust without turning every operational choice into consensus governance,” he says.

Define Success Before Choosing the Solution

For Dorothy Riviere, Founder and CEO of Work Resilience, the biggest mistake leaders make is asking clinicians to evaluate a solution before establishing what the solution actually needs to accomplish.

“The best time to give clinicians influence over a decision is before the decision gets made, not after,” she says.

That means starting with the work itself.

“Start by asking clinicians what actually makes a patient encounter, a procedure or a course of care succeed, in their own judgment,” Riviere says. “What they need in the room, the information, the time, the conditions, to do the work well.”

This approach also helps organizations avoid creating a permanent governance structure for every future decision. Once leaders understand the conditions required for effective clinical work, those principles can become design criteria that guide subsequent decisions.

“Genuine influence isn’t more governance,” she says. “It’s asking clinicians what success looks like to them, before you build around them instead of with them.”

Build Clinical Leadership Into Operations

Dr. Peter Fotinos, Chief Medical Officer at Excel Medical, argues that clinician leadership should not sit beside operations as a separate layer. It should be part of the operating model itself.

“Clinician leadership shouldn’t be another layer of governance,” he says. “It should be built into how the organization operates.”

Fotinos points to a simple reason: Clinicians have firsthand knowledge of what patients need.

“Great clinicians know what patients need because we listen to them every day,” he says.

The result, he argues, is not necessarily slower decision-making. The opposite can be true when clinical expertise is available early enough to prevent avoidable rework.

“Their perspective helps companies make faster, smarter decisions that work for both patients and the business,” Fotinos says.

Give Frontline Clinicians the Power to Stop Bad Designs

Mahendran Chinnaiah, Digital Healthcare Architect at a major U.S. healthcare and pharmacy services firm, recommends replacing traditional advisory boards with small, focused teams that include practicing clinicians throughout the design process.

“Embed frontline clinicians directly into agile sprint teams rather than standing committees,” he says. “Heavy advisory boards usually create bureaucratic lag without giving providers real leverage.”

His proposed model gives clinicians something more meaningful than a seat at the table: explicit authority to stop a design that creates unacceptable clinical friction.

“Bring practicing clinicians into short, focused product and workflow sprints as embedded co-designers with explicit veto power over clinical usability,” he says.

That does not mean clinicians control every dimension of a project. It means they have a defined safeguard over the part of the decision where their expertise is strongest.

Chinnaiah also recommends rotating short-term advisory sprints with protected time. That gives leaders access to diverse frontline perspectives without turning participation into a permanent obligation.

Match Decision Rights to Risk

Tirumala Ashish Kumar Manne, Principal Cloud Architect at Optum, frames the challenge as an architecture problem rather than a governance problem.

“Treat clinician influence as a decision architecture problem, not a committee problem,” he says. “Classify decisions by reversibility and clinical impact. Low-risk, reversible calls, like workflow changes or scheduling templates, go to point-of-care teams with delegated authority and no escalation.”

More consequential decisions receive more deliberate clinical participation.

“High-impact, hard-to-reverse calls, like platform selection or staffing models, get a named clinician co-owner and a time-boxed consult, with a default to proceed when the window closes,” he says.

Manne also recommends publishing decision rights on a single page so employees know who decides, who advises and who is informed. The organization can then measure whether those decisions produce better operational and patient outcomes.

“Authority placed at the right layer speeds the organization up, because fewer decisions travel upward.”

“Decisions about operations, tech, staffing and strategy should reflect what is actually happening at the point of care.”

– Jason Foodman, Managing Director at Archetype Growth

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Bring Feedback Into the Workflow

Jason Foodman, Managing Director at Archetype Growth, says organizations can often avoid another governance mechanism by making clinician feedback part of the systems they already use.

“Instead of adding committees or approval layers, organizations should integrate clinician input into existing workflows and technologies,” he says.

The reason is straightforward: Care is delivered where clinicians and patients interact, not where an executive committee reviews a project plan.

“Healthcare happens where the clinician and patient meet,” Foodman says. “Decisions about operations, tech, staffing and strategy should reflect what is actually happening at the point of care.”

Foodman warns that organizations can otherwise optimize for administrative objectives while making clinical work harder. He cites the possibility of an EHR workflow optimized around billing that creates unnecessary friction during patient encounters.

“Integrated EHR feedback tools, collaboration platforms, workflow dashboards and AI-powered analysis can reveal frontline concerns in real time,” he says. “Leaders can use that information to strengthen the feedback loop between clinicians and the administrative leaders making decisions that impact their work.”

Protect Clinicians From Technology Overload

Rajani Kumar Sindavalam, Systems Engineering Leader at HCL America Inc., argues that giving clinicians influence does not mean asking them to become technology experts.

“As AI and automation are increasingly integrated into medical devices and services, keeping clinicians in the loop is essential to ensure safe, effective deployment,” he says. “Leadership must protect clinicians from cognitive overload by preventing rushed technology pushes that are difficult to analyze or understand.”

He recommends a clear division of responsibility: R&D and technology teams should translate technical nuances, while clinicians focus their authority on workflow efficacy and patient safety.

“By establishing this clear division of labor, organizations can maintain agility and avoid heavy governance layers while ensuring that technology always serves to empower, rather than overwhelm, the frontline medical workforce,” he says.

“Clinicians need real decision rights, not more meetings or advisory roles.”

– Sriharsha Chavali, Engineering Lead for a leading national dental services organization

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Give Clinicians Real Decision Rights

Sriharsha Chavali, Engineering Lead for a leading national dental services organization, draws a sharp distinction between participation and authority.

“Clinicians need real decision rights, not more meetings or advisory roles,” he says.

For decisions affecting safety, quality, workflow, access or professional practice, he recommends bringing clinicians into the process early enough to shape the result.

“It requires targeted clinical co-ownership: clarity on which decisions need clinical input, who makes the final call and who executes,” Chavali says. “For a new clinical platform, clinicians should define workflows, identify safety risks, test usability and set priorities. They need not weigh in on every contract, infrastructure or administrative detail.”

The model keeps accountability clear: Clinicians influence the elements tied to care quality and workload, while operations leaders remain responsible for resources and execution.

“Close the loop. Input without visible influence erodes trust,” Chavali says.

Use Small Councils With Clear Authority

Rather than creating a large permanent governance body, Asaad Hakeem of SARC MedIQ Inc. recommends small councils that have authority over specific workflows.

“Create small, rotating clinician councils with authority over specific workflows, clear metrics and rapid feedback cycles,” Hakeem says.

The rotating structure allows organizations to hear from different frontline perspectives without creating a standing committee that becomes responsible for every decision.

It also keeps accountability visible.

“Leaders retain execution speed while ensuring decisions are shaped by the people who understand patient care and frontline realities.”

Use a Physician Cabinet for Strategic Issues

David Zechman, President of The Zechman Group and Retired Hospital President and CEO, points to an approach he implemented directly during his time as a hospital CEO: a small Physicians/CEO Cabinet.

“The Cabinet included physicians who would be willing to meet with me as a small group every other month to discuss major hospital challenges and strategies as well as internal political hospital or medical staff concerns,” Zechman says.

Zechman says the forum gave him a way to incorporate physicians into governance and operations while keeping the group small enough to remain useful.

“This forum was extremely helpful in allowing me to include physicians so that they could participate in and have a genuine influence on hospital governance and operations,” he says.

How to Give Clinicians Influence Without Slowing Decisions

• Make clinical participation decision-linked. Define which decisions require clinical input and give the participating clinicians explicit authority, timelines and access to the information they need.
• Define success before selecting a solution. Ask clinicians what a successful encounter, procedure or workflow requires before choosing technology, staffing models or processes.
• Build clinician leadership into the operating model. Treat clinical expertise as part of how the organization operates rather than as a separate governance function, allowing leaders to make faster decisions grounded in patient needs.
• Embed clinicians in focused design teams. Put practicing clinicians into short, focused design and implementation teams where their expertise can shape decisions in real time.
• Match decision rights to risk. Delegate low-risk, reversible decisions to frontline teams while assigning named clinical co-owners to high-impact decisions.
• Put feedback inside existing workflows. Use EHR feedback, dashboards, collaboration tools and other operational systems to capture clinical concerns without creating another meeting structure.
• Protect clinicians from technical overload. Let technology and R&D teams translate technical complexity while clinicians retain authority over workflow effectiveness, usability and patient safety.
• Give clinicians real decision rights. Advisory input is insufficient when a decision affects safety, quality, access, workload or professional practice.
• Use rotating councils for focused issues. Small councils with defined authority and rapid feedback cycles can provide diverse clinical perspectives without permanent governance overhead.
• Create a trusted channel for executive-clinical dialogue. A small physician cabinet or similar forum can give senior leaders candid clinical perspectives on major hospital challenges, strategies and medical staff concerns without involving physicians in every operational decision.

Make Clinician Influence Count

Giving clinicians genuine influence does not require healthcare organizations to slow every decision or build another layer of governance. The more productive question is not whether clinicians should have a seat at the table, but where their expertise is essential—and how much authority they should have when they get there. When that is clear, leaders can move quickly without leaving clinical realities behind.

As healthcare becomes more dependent on technology, AI and increasingly complex operating models, the distance between an executive decision and its impact at the bedside will only grow. Organizations that close that distance by bringing clinicians meaningfully into the decisions that affect care will be better positioned to move with both speed and confidence. The goal is not to give clinicians a voice in everything. It is to make sure that, when their voice matters most, it can actually change what happens next.