One hallmark of America's rapidly changing health care system is the evolving role of physician leaders who have chosen to wear two leadership hats as both doctor and administrator. As physicians they must make quick and decisive clinical decisions about a patient’s care, while as physician-administrators they often face longer-term organizational challenges that require different types of problem-solving approaches. In this conversation, Chris DeRienzo, M.D., senior vice president and chief physician executive at the American Hospital Association, explores how today’s physician leaders can reconcile the demands of two different jobs and support both the patient and their organization's long-term goals.