In this episode of SoundPractice, host Mike Sacopulos explores the critical skill of strategic thinking with Michael Gardner, MD, vice president and administrator of Women's and Children's Hospital at University Health in San Antonio, Texas. Gardner shares his extensive journey through physician leadership and breaks down why strategic thinking is essential for physicians who want to shape the future of healthcare.

Michael Gardner is board certified in obstetrics and gynecology as well as maternal fetal medicine. He is a certified physician executive (CPE) and in 2025 became a fellow of the American Association for Physician Leadership.

Why strategic thinking matters for physicians: Physicians bring a unique perspective that is essential for improving American healthcare. With healthcare consuming roughly 20% of GDP and outcomes that lag behind other developed nations, physician leaders must actively participate in strategic decision-making rather than exclude themselves from these conversations.

Strategic vs. clinical thinking: While clinical thinking focuses on immediate patient care with narrow attention to detail, strategic thinking requires a broader view of internal and external environments, long-term organizational goals, and the ability to embrace foresight and ambiguity. The key difference lies in scope and timeline — strategic thinking means planning months and years ahead.

Strategic thinking can be learned: Though some physicians may naturally gravitate toward systems-level thinking, strategic thinking is a skill that can be developed through mentorship, education, practice, and progressive leadership experiences. Starting with smaller leadership roles and building confidence prepares physicians for larger strategic challenges.

Physician leaders as translators: Successful physician leaders must learn to speak both clinical and business languages. While they don't need to match their CFO's financial expertise or their COO's operational knowledge, they must understand enough to communicate effectively with administrative colleagues and translate strategic concepts back to medical staff.

Gardner and his colleague Mark Guadagnoli, PhD, are developing a strategic thinking and planning course series for AAPL, including:

- An online strategic thinking course

- "The Who, What, Where, and When of Strategic Planning" course

- A hybrid strategic planning workshop in 2026 where participants will create actual strategic plans with ongoing guidance and feedback.

Learn more about the American Association for Physician Leadership at www.physicianleaders.org