Key Takeaways
- Integrate clinical expertise with business operations to effectively navigate the transition to value-based care and workforce shortages.
In the ever-evolving landscape of U.S. healthcare, “clinical strategy” is fast emerging as a must-have leadership discipline—one that demands fluency in both the art of patient care and the science of business operations. Yet for many, the term remains unclear, often dismissed as just another buzzword. Why does clinical strategy matter now? Because healthcare organizations face relentless pressure to deliver better outcomes, control costs, and drive innovation—often all at once. With systems stretched by COVID-19, workforce shortages, and shifting reimbursement models, leaders must fuse clinical expertise with business acumen to survive and thrive.
That’s exactly what Alex Tang, MBA, PA-C, Vice President of Clinical Strategy & Innovation at CareAbout, brings to the table. In our conversation, Alex draws from his journey as a trauma and neurosurgery physician assistant, primary care clinician, business school graduate, and health system executive, giving us a blueprint for how clinical strategy works in real life. If you want to understand how to implement strategy that actually moves the needle—instead of stalling in the C-suite—Alex’s story offers both inspiration and practical steps.
Clinical strategy is the intentional integration of clinical knowledge, business principles, and population health management to drive both patient and organizational outcomes. In the words of Alex Tang, “Clinical strategy essentially is an interchangeable term. I would say it’s similar to population health. It entails a lot of understanding not only the healthcare business side but also the clinical aspect of it and population health management as well.” In short, clinical strategy bridges the gap between medicine and management, leaning more toward business but leveraging a strong foundation in direct patient care.
Why is this relevant today? U.S. health systems are at an inflection point. They must:
Transition to value-based care models.
Navigate physician shortages and workforce burnout.
Integrate technology (from EHRs to telemedicine) into workflows.
Respond to population health imperatives, including social determinants of health.
Satisfy both regulatory and payer demands on quality and cost.
Leaders can’t afford to silo clinical and business functions anymore. As Alex explains, “It’s a really unique blend… you have to leverage clinical experience, but also business school knowledge. The MBA is a good framework, but the hands-on, on-the-ground experience is just as vital.”
Becoming a clinical strategist is a process of broadening one’s scope from bedside care to systems thinking, and intentionally layering business expertise onto a clinical foundation. Alex’s own path is instructive. He began with a decade of hands-on clinical work:
Surgery and Trauma: “The first five years of my career were spent in a public hospital system… I trained with the best surgeons around in the trauma field and really learned how to manage critical care.”
Neurosurgery: “I moved next to NYU Health, where I developed tactical skills in neurosurgery.”
Primary Care, Asian Community Focus: “I spent five years in primary care, part-time in the Asian community. I wanted to learn about managing healthcare needs across cultures and settings.”
Alex emphasizes the importance of being “well-rounded”: “As a PA, we’re trained to be well-rounded. But to get perspective, I needed to move beyond one field… hopping into primary care allowed me to get perspectives I didn’t have.”
The pivot to strategy came after hitting a career ceiling: “At a certain point, you hit ceilings. It’s not that I was a master at my prior skills, but I wanted to learn more about how the health world works.” That meant business school, networking, and, crucially, operational leadership in independent physician associations (IPAs) and management services organizations (MSOs).
Key steps to becoming a clinical strategist:
Accumulate broad clinical experience—across settings, patient populations, and clinical roles.
Pursue formal education in business, finance, or healthcare administration.
Build relationships and networks outside your immediate clinical sphere.
Step into roles that require both clinical and operational oversight (e.g., IPAs, MSOs, ACOs).
Clinical strategists translate clinical realities into scalable, sustainable business models—often under immense uncertainty. In practice, this means:
Leading population health initiatives and quality improvement projects.
Designing, implementing, and optimizing care delivery programs (e.g., house calls, mobile testing).
Negotiating with payers and providers to improve contract terms for clinicians and organizations.
Integrating clinical, operational, and financial data to guide decision-making.
Alex recounts his work building a mobile COVID-19 testing program as a case study:
“The board came together and basically said, ‘Hey, we want to do testing, and we want it to be mobile.’ We didn’t have the resources for it… So we backtracked: What are the components? How do we protect staff? What precautions do we need? We started with research, built a prototype in a parking lot, leveraged partnerships, and operationalized the program.”
Clinical strategists matter because they:
Break down silos between business and clinical staff.
Spot operational risks and clinical blind spots before they impact outcomes.
Accelerate change management by “speaking both languages.”
Foster buy-in from front-line staff, not just senior leadership.
The core skills of a clinical strategist are resilience, systems thinking, adaptability, and a bias for action. Alex credits his background in trauma surgery with developing his “Mamba mentality”—a term borrowed from Kobe Bryant’s legendary approach to relentless improvement:
“The skills of not fearing failure, of trying multiple times on certain things but not succeeding and keeping on trying… It’s a go-to attitude. Half the battle is having the audacity to attempt to solve that problem.”
“In trauma, there are so many people involved, everyone has distinct roles… I was able to play all those roles. If a role is missing, I can take on that role. It’s about clear delineation and fitting into a system.”
To develop these skills:
Don’t fear “small” roles—every contribution matters.
Learn to predict organizational needs 1-3 years ahead.
Take initiative in undefined or ambiguous situations.
Cultivate operational and clinical allies; build trust across departments.
Treat business operations with the urgency and clarity of clinical emergencies—without succumbing to panic.
The single biggest barrier to successful strategy execution is a lack of buy-in from those actually doing the work. Alex is unequivocal:
“Does the project fit the organization’s mission and vision? Is everyone aligned? Do you have strong buy-in—not just from leaders above, but from those below?”
“Often what I see is executives who are sold on a project, and then it ends up not working because they’re not the only players in the game.”
To close the gap between strategy and operations:
Ensure Mission Alignment: Every project should map directly to organizational goals.
Secure Front-Line Buy-In: If staff don’t see the value, reframe or rethink the project.
Integrate Clinical and Business Perspectives: Find the middle ground; sometimes the business case makes sense but isn’t clinically practical.
Communicate Outcomes, Not Just Processes: Sell the “why”—how this work will benefit patients, staff, or community.
Alex’s practical advice: “If you’re adding more work, that’s fine—but is there a good outcome at the end? Start selling that part. In healthcare, you’re always helping people, but you have to reinforce that message.”
Non-clinical executives need trusted clinical allies—ideally those with business savvy—to bridge the gap. Alex’s prescription:
“You need to have really strong clinical allies, and not just clinical but those who also have business experience, such as myself.”
“Often, clinicians will always… there’s a lot of pride within the profession, especially between patient and clinician. When you start disrupting that, you start losing support.”
How to identify and cultivate clinical allies:
Look for clinicians who mentor others and aspire to leadership.
Invest in leadership development for clinicians—sponsor MBAs, fellowships, and rotations in administrative functions.
Involve clinicians early in the design and rollout of strategic initiatives.
Build “hybrid” roles that formalize this dual expertise.
Alex’s takeaway: “Healthcare is a business and an engine that needs to keep running, but you need clinicians who understand that to drive the business or be tied intimately to the business leaders making decisions.”
Anyone can cultivate the courage and adaptability needed to drive clinical strategy—but it requires deliberate practice and mindset shifts. Alex suggests:
“There’s no role that’s too small, and your limitation is what you define it.”
Proactively define and shape your role, especially in new or ambiguous settings.
Get to know your organization’s mission, vision, and 1-3 year strategy.
Look for ways to integrate your work with, not duplicate, what others are doing.
Practice leadership in small groups or volunteer settings—Alex’s story about bringing a basketball to Chinese school to foster connection is a reminder that leadership starts informally.
Healthcare’s most urgent challenges—cost containment, patient experience, care delivery innovation—can’t be solved by business or clinical minds alone. Clinical strategy, as exemplified by leaders like Alex Tang, MBA, PA-C, is about blending the best of both worlds. If you’re a business leader, invest in clinical relationships. If you’re a clinician, seek opportunities to build business acumen. And if you want to lead the next wave of healthcare transformation, remember Alex’s advice: “Your limitation is what you define it. You have to have the audacity to try.”
Actionable Insight:
Take inventory of your current leadership team and project workgroups. Where are the “bridges” between clinical and business? Where are the silos? Challenge yourself to identify at least one area where a clinical strategist—or “Mamba mentality”—could unlock better results. If you don’t have such a bridge, it’s time to build one. As U.S. healthcare continues to transform, the leaders who thrive will be those who master the art and science of clinical strategy.
Alex Tang, MBA, PA-C, is Vice President of Clinical Strategy & Innovation at CareAbout. This conversation was hosted by Cole Lyons for The American Journal of Healthcare Strategy.
<p>hello everyone this is Cole from the American Journal of healthc care strategy joining me this sat this rainy Saturday in the Northeast here is Alex Alex please go ahead and introduce yourself hey everyone my name is Alex I am a clinician by trade I'm a physician assistant by trade I serve as a vice president of clinical strategy and Innovation for one of the msos out there happy happy to be on [Music] thank you so much for your time this uh afternoon and you know as that clinical strategy position that you have I want to ask it's not a common term I guess you know it's becoming more common but what is clinical strategy uh clinical strategy essentially is an interchangeable term uh I would say it's similar to population Health it there entails a lot of understanding not only the healthcare business side as well as understanding the clinical aspect of it and understanding the population Health Management of it as well too so it's like a really blend I'd say it's it's closer more on the business side but really leveraging um the clinical experiences and uh for me you know being a clinician for over the first uh 10 years of my experience which I should have I should have elaborated more in my introduction hly let me backrack some more that you know being a clinician I I you know I I started 10 years in my earlier uh career in surgery the first five years of my career was served in a public hospital system called bellev and I I've had the opportunity to train with one of the you know the best surgeons around in the trauma field and really learned a lot of the the critical care experiences and how to manage trauma and from there transferred my skill set over to the public more of a private hospital setting right right across next to it with the NYU health system and over there more tactical skill set was learned in terms of a neurosurgery standpoint so I spent five years there and then bridging between the my trauma surgery my uh neurosurgery I spent five years as well too in Primary Care setting and that's more in the primary care part-time in the Asian community and I I honestly I did that because I wanted to really take on some of the surgical knowledge into the primary care world and learn more about the primary care world so you know as a PA we're we're more trained to be well-rounded and so like for me it's like how do I be more well-rounded when I'm just exposed to like one field and so for me hopping into the primary uh field allowed me to get this additional perspective that I didn't have one about like the Asian culture in terms of managing their healthc care needs and at the same time understanding primary care and then at the same time being able to leverage some of the the general surgery knowledge over and an acute care Care Surgery knowledge over at the primary care setting as well too so he's best in both worlds eventually I I pivot over to like the IPA space after graduating from and getting a business degree and the whole reason why I did that was because I was very you know at certain set at certain time point in your life in your career you will feel that there's some ceilings that you'll hit and not not to say that I was a Mastercraft at my at my prior skill sets but at the same time it's like but how do I learn and expose more and understand more of how the health world looks like and so that's why I went to business school and and from there really understood sort of like the the fundamentals of of you know Finance the things that I have not exposed to as as a PA like how does health insurance work the healthcare economics of things how to look at performa what's marketing like the It All That infrastructure all that stuff is you know it's very important at the same time um I was also building my network at the a New York City Market as well too while I started my own networking group called at at the at that point called Healthcare social network and now spun off to call it the hive and so I throw these monthly um events out just so that I can really get exposed to what other folks are doing so so that that so from from the clinical side that that transition into the business side was me stepping into the IPA World which is independent practice Association so for for those that don't know ipas are essentially organizations that really help with a population help standpoint point for the primary care world that are small business owners so they so one good example is they help small business physician owners to negotiate contracts and rates on behalf on their behalf and to really advocate for them and help them from like a credentialing standpoint and from like a payer provider relationship standpoint and at certain degree of uh ipas they would also help from a population help standpoint in terms of quality metrics heus yeah so those are those are those those are really the major is things and then eventually transferred my knowledge into more operational side helping to build Singleton entities out there helping to really stand up stand up clinical programs like house call program which is very important um so it is this kind of interesting blend between that clinical experience you had as a PA and that business school knowledge that you have from getting your MBA yeah yeah I mean honestly NBA is just just a good framework a lot of the knowledge that I've learned was really hands-on experience and and often time it's it's things that I've never been exposed to and and have not saying I'm super courageous but like just having the the the audacity to to attempt to try to solve that problem and and and to provide a solution and and that that's I guess that's half to battle it's like really having that that comfort of being like amazingly uncomfortable situation what are some of those situations and some of those problems that you're overcoming and and finding yourself in I can tell you historical problems that that that i' I've you know historically like back then when when the house call was up it was around 2019 2019 and the program was growing and then the pandemic hit and then the pandemic hit and then and then from there we had to like you know operations because we were going to people's home and people were like you know the news was was showcasing the amounts of deaths out there and then at the same time no one really knew what to do only thing we knew was you know folks were really driving into the hospitals and and they were getting infected there and and getting getting exposed to co and so like you know I think our organization at that point my organization at that point wanted to do something called mobile testing and so we we the board came together and basically said hey we want to do testing and we want to want it to be mobile and and so that you can drive around different communities and and at that point it's like okay how do we operationalize this when we don't have the means and the resources for it so and then and then okay then then from there kind of backtrack what are the components we need mobile so it has to be in a vehicle the second thing is okay we just got to and then and then how do we how do we cond cond conduct the test and so we reached out to our our Laboratory Partners just to understand exactly like the tests like how to like what what are the supplies are that that are that are needed um and then what are the supplies to protect our staff and then what are the um precautions that we need to be concerned about so we have to read up on CDC so it's a lot of like research just to get the basics infrastructure and then from there um once you get the basic infrastructure and you start mocking up a Proto uh like a like a prototype so we did a really first iteration of a telephone booth just to like just to get some traction to get something going and then from there started off with a stationary version first which we partnered off with uh organizations out there leveraged their parking lot and um at the same time we were working with another payer that helped that that lend us their vehicle and so like we we had some like components pieced here and there but it was like the first iteration of it and at the same time people were scared and so like how how do you how do you combat that fear so at that time I'm like okay as long as you know be me being the the person that's really leading to charge as long as I'm on the front lines like literally at the front line like all dressed up in half suit then then people will be like less less fearful right at least there's some ease of of ease of mind and so that was like sort of my mindset at that point you know unknowing like the repercussions that could have happened right right like now now I'm talking about this I'm joking about this but like you know God forbid something actually happened at that point then I can't joke about it but but now I could like safely say like we did it you know the first iteration went well and the next thing you know we were able to partner with another Health another health plan that lent us the RV and then at that point okay we just retrofited the door so it's like a one-way oneway testing with a kangaroo box so we can just get the specimen out collect it back in Sterly so we were thinking of like a a close system so that we can and at the same time it's mobile too so we leveraged uh one of the payers uh RV had their drivers they were helping out that that sort of ramped up next know we were on the news I was on some of the the the Chinese media newspaper we were interviewed by like MTV News that was the weirdest thing ever and then and then and then all the politicians started like coming out from the Woodworks taking pictures and and and and I think I think that was probably my most memorable experience at least in that from the pandemic standpoint because you know I I I stopped I stopped practicing in 2018 so watching all my all my friends just like at the hospitals like you know at the front line we want to also contribute at the same time so at least it gave me a sense of sense of contributions that that to the community so but that that's a tremendous task that you were kind of given to do by leadership I mean they essentially just said we want to do this and then you have to figure it out you know I I think a lot of people would be very intimidated by that even experienced Executives would be intimidated by that what skills have you developed that allowed you to accomplish that successfully the skills of not fearing failure the the the skills of the experience of of um trying multiple times on certain things but didn't succeed and kept trying again it's just the it's the M like what Kobe Bryan says the the mama mentality a little bit of and why do you have why do you have that Mamba mentality what led you to to have that when other people don't I think I don't know upbringings it's all it's a lot of things it's it's up it's so many factors that I really it's hard to kind of identify for me and I think it's always the the go-to attitude that I always had I think even as a as a kid I the fondest thing I remember of leadership as a as like I don't know how old I was 8 n you know being in Chinese school I I thought about this a lot of time like we we we used to everyone just go to class and would just like go home afterwards and one day I I brought a basketball just so that everyone could you know get some people out just to socialize and play and just and then eventually that became more of a regular thing and then that grew into more like I still I'm very close friends with the folks at in Chinese school and so like I I felt like that was sort of like the the beginning of my developing that type of skills at least the social skill side and that and and that really did help me I think that's how I felt I don't know how do you think people can develop I guess that knowledge that you had you know you said it was on the job but you know not every job is the same you know it's not everyone could Implement what you were able to implement what do you think some people could do like myself you know I'm early in my career compared to you what can I do to learn how to implement things like this and how to be like you said have that Mamba mentality you know the where you're ready to handle these situations what could I do to to get there I I think one of the things I I often tell people is that there's no role that's too small and there and I think there's no that that you your limitation is based on what you define it and and my when I first pivot over to the IPA space I was I was the only PA in leadership in in that organization and the funny part is they didn't know what to do with me they didn't they didn't have a role for me and for me I I took my I took upon my self to kind of Define that role and and obviously it's just it's just not not me just creating It But Me interacting with folks understanding what everyone's roles are understanding the company's mission and vision and then understanding what the company where the company is going to go and and then try to predict in one to three years where where they're heading and then from there and then from there see what I can do to contribute to to help push that organization to T destination and what I'm doing shouldn't be inter interfering or overlapping with what other folks are doing it should be integrating into their workload and and be a catalyst to make that thing happen so so I think I think trauma being my experience in trauma helped develop that because when you're in trauma surgery there are so many people involved and everyone has very distinct roles and when a trauma comes in usually the ER attending comes in and they they would do the first assessment they would follow their guidelines in terms of when to activate trauma then the trauma team comes in that's when that's when my me and my team comes in my attending and the attending would be on the sidelines the senior resident would be below the the foot of the stretcher you'll have two nurses on the side putting in IVs you'll have an intern putting in orders uh and then and then someone on the side would support someone would also do the the assessment on the patient while yelling out what the assessments what they're seeing and then whatever they're seeing the chief resident is the one that's sort of like digesting the the environment the data point that's coming from the resident the vital signs that's coming in and then from there make some sort of a determination of okay we need someone to go to the blood bank oh we need to get a specialist down here right away we need to prep radiology and then you have folks on the side like making sure that these orders or these these orders are are being executed so I was able to play all those roles um and if the role is missing I can take on that role so so it's it's it's understanding the but it's really clear delineation of roles and then fitting into a system so I think I think that experience allowed me to be able to also be a strong execution be able to Tri certain situation and at the same time because everything is split seconds you know that's life and death but in a business side it's not life and death but I can still treat it as that right and then start operationalizing things really quick so yeah so yeah yeah that's that's excellent very that make that makes a lot of sense one of the issues a lot of people face that I hear about is you know they're good at operations they can make really good decisions Under Pressure but when it comes to implementing a an overall strategy in a split second that's where people seem to have a lot of trouble do you have any ways that you look at organizational strategies when you go to implement them in operations in like I guess it do you see a lot of organizations that struggle with that and and how do you think organizations could be better at doing that yes a good example of why organization what okay let's start let's talk by talking about the project itself right does the project fit the organization's mission and vision are everyone in the team and the company aligned to that mission and vision is the project do you have strong buyin from not only the leaders above but the leaders Below on this on the current plan and if if not why do you not have buyin on the project big the biggest issue with executing projects is that you don't have strong you don't have to have all the buyin but you you from my standpoint you need to have the buyin of the folks that actually on the ground doing the work if they don't see the value of it right then either there there really is no value or you're adding more work to the workload right or and and and here's the thing if there's more work that's fine is there a good outcome or end product to the the thing you're trying to solve and if that is true then start selling that part right you're helping people it's true you are helping and Healthcare you're always helping people right then and then from there it's all at the same time it's all propaganda at that point but it's true right you're helping people you're reinforcing that message and then if they buy in then that that's one good thing often time what I see is you have Executives that are really sold to a project and then then it ends up not working because they're not the only players in the game right so that that's sometimes is the disconnect between Executives and the folks at at the ground and I try to strike a balance between in the middle and it's not just and and I'm not just striking a balance between those two I'm also striking a balance between like the clinical side and the business side and try to find that Harmony as well too because sometimes on a business side makes sense on the clinical side it's like you're not doing either you're not doing a good service for the patients or it's actually not efficient for something or whatever the case may be so you have to find this Middle Ground you know you're you H you have a good position in that in a sense that you have had lots of clinical experience and then now you also have business experience what can the executives do who only have the business EXP experience how can they kind of bridge that gap between the business and the clinical side they need to have really strong clinical allies and it's not just a strong clinical allies but you need a clinical alies that has also the business experience such as myself right because often times the clinicians will always and I'm not just saying clinicians like Pas or MDS I'm also saying like nurses like there's a lot of Pride Within profession and there's this Pride between the patient and the clinician relationship so when you start disrupting that you'll start losing a lot of support from the clinical side so you need someone who's able to kind of help to bridge that Gap how do you identify those clinical allies I that oh that's why it's important to have good mentees that you Mentor that are clinicians that aspire to being leaders I I personally think then Healthcare yes while we do need your mba's healthc careers that look at the bottom line and the economic side to it because Healthcare is a business and and it's an engine that needs that it's a cycle but at the same time you need the clinicians who also understand that to also help either Drive the business or or be very intimately tied with the The Business Leaders that are making the decisions y you need to have them in your cabinet I I agree very much with that I think that's excellent advice and and thanks again for joining Alex I want to keep us within uh your time for the day but I really appreciate you joining and I think you answered all the questions I had I think it's going to be very valuable for our audience well thank you for having me</p>
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