Professor Erwin Loh FRACMA, President of RACMA

Dr. Paul Eleftheriou FRACMA, Principal, Nous Group

Healthcare systems are becoming more complex and resource-constrained, and expectations of Chief Medical Officers (CMOs) are shifting in response. The role of the CMO now sits at a crossroads. At a recent event hosted by the Royal Australasian College of Medical Administrators (RACMA) and Nous Group, healthcare leaders came together to explore the future of the CMO and the capabilities needed to lead effectively through the challenges of 2030 and beyond.

Professor Erwin Loh, President of RACMA, formally opened the event and set the tone for a forward-looking discussion. He reflected on the evolving nature of healthcare leadership and called for teaching and leadership development to begin early in medical careers. He highlighted key trends shaping the sector, including a pivot towards prevention, home-based care models, and personalised, predictive approaches to treatment. He also challenged attendees to consider how technology, particularly artificial intelligence, could redefine the boundaries of clinical leadership.

The CMO of 2030: A Systems Thinker and Innovator

The expert panel discussion explored the evolving expectations of the CMO in greater depth. Panellists noted that although the role still holds significant influence, many clinicians do not view it as a strategic leadership position. Instead, they often see the CMO as a punitive authority. The panel agreed that shifting this perception is essential for CMOs to lead meaningful change across the health system.

A key theme that emerged was the shift from expert clinician to expert leader, a transition that demands more than technical skills. Panellists stressed the importance of systems thinking, an appetite for navigating ambiguity, and a focus on population-level impact. They argued that the CMO of 2030 must be a creative problem solver who leads service innovation, embraces digital health, and uses data to improve outcomes. They also called for a mindset shift, viewing risk not as something to avoid but as a driver of progress.

Building the Future: Insights from Small Focus Group Discussions

Participants identified a diverse range of skills that future CMOs must possess to lead effectively. These include:

• People and leadership skills: Collaboration, negotiation, conflict management, and the ability to hold constructive tension.
• Systems and strategic thinking: Aligning clinical and organisational goals and translating vision into operational action.
• Clinical credibility and governance: Maintaining trust among peers while ensuring safe, high-quality care.
• Digital and data fluency: Leveraging digital health tools and interpreting data to generate actionable insights.
• Financial acumen: Understanding health economics and sustainable service delivery.
• Curiosity and creativity: Leading change, experimenting safely, and responding to emerging challenges.
• Community and consumer connection: Designing services that reflect real needs and social determinants of health.

Participants discussed how embedding these capabilities into the CMO role could deliver transformative outcomes. They envisioned more agile and resilient health systems, better prepared to manage disruption and strengthen future models of care. They saw improved patient outcomes, equity and safety as direct results of stronger system design and oversight. They also highlighted how deeper engagement between clinicians and executives could build a shared vision and clearer priorities, while stronger accountability and resource stewardship would help rebuild trust in the system.

Risks and challenges

Participants expressed optimism about the future of the CMO role but also identified major challenges to implementing change. They pointed to fragmentation across jurisdictions and sectors as a barrier to harmonising and standardising roles. They also highlighted ongoing resistance from traditional medical cultures and leadership structures, along with limited authority and influence in some CMO positions.

Participants also identified other challenges, including limited training pathways for non-clinical skills, inconsistent investment in digital infrastructure, and misaligned expectations between employers, government and the profession. They warned that without adequate support, increasing demands on the role could lead to burnout among CMOs.

To evaluate the impact of these changes, participants proposed a mix of short and long-term metrics across four domains:

• Health system performance: Patient outcomes, quality and safety metrics, and service efficiency.
• Leadership development: Succession planning, workforce capability uplift, and CMO engagement levels.
• Organisational culture: Staff satisfaction, reduced ethical distress, and strengthened collaborative decision-making.
• Strategic influence: Evidence of CMO-led reforms, RACMA visibility, and system-level improvements.

Forward into the future

As Professor Loh noted in his opening remarks, the future of healthcare leadership is not just about adapting to change but actively shaping it. The CMO of 2030 will need to be a systems thinker, a digital innovator, and a compassionate leader who can navigate the moral complexities of the role. By embracing these challenges, CMOs can help build a healthcare system that is not only resilient but also equitable, innovative, and patient-centred.

Acknowledgements: We acknowledge the contributions of Rodger Paul, Manager, Nous Group, Gemma Ludski, Consultant, Nous Group, and Callum Chambers, Marketing Manager, Nous Group.

Authors

Professor Erwin Loh

Prof. Loh is President of the Royal Australasian College of Medical Administrators and National Director of Medical Services for Calvary Health Care. He was previously Group Chief Medical Officer at St Vincent’s Health Australia, Chief Medical Officer at Goulburn Valley Health and Chief Medical Officer of Monash Health. He has qualifications in medicine, law and management. He has adjunct professorial appointments at Monash University, University of Melbourne and Macquarie University. He has been an invited speaker at local and international conferences, and has published books, book chapters and journal articles on leadership, governance, AI and health technology. He is a member of the Association of Professional Futurists. He received the Distinguished Fellow Award from RACMA in 2017 for “commitment to governance, research and publication”.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: President of RACMA; Associate Editor for BMJ Leader

Dr. Paul Eleftheriou