From Clinical Practice to Executive Leadership: Two Kaiser Permanente leaders reflect on how their clinical backgrounds shaped their journey to executive leadership.
By Renee Clarke, DrPH, MPH, RN and Deborah Ellis, PhD, FACHE, CPHQ
Every healthcare executive brings a unique perspective to leadership, shaped by the patients they
have cared for, the teams they have worked alongside, and the challenges they have navigated
throughout their careers. While physicians and nurses have traditionally followed the most
visible paths into executive leadership, today’s healthcare organizations increasingly recognize
the value of leaders from a wide range of clinical disciplines. Their diverse experiences
strengthen decision-making, foster innovation, and broaden how organizations approach patient
care, operations, and strategy.
For this issue of the CAHL Newsletter, the Clinical Leadership Council spoke with two Kaiser
Permanente executives whose careers began in very different clinical professions. David Snyder,
PT, and Ruben Valencia, PsyD, MBA, shared how their clinical experiences continue to
influence the way they lead organizations today.
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David Snyder, PT
Healthcare Administrator, Senior Director of Operations, Kaiser Permanente
David Snyder serves as Healthcare Administrator and Senior Director of Operations for Kaiser
Permanente. Beginning his career as a physical therapist, he has spent his professional journey
expanding his impact from individual patient care to leading operational excellence and systemwide performance improvement initiatives. His leadership philosophy centers on servant leadership, collaboration, and creating environments where teams can thrive.
What was your original clinical discipline, and what drew you to it?
I began my career as a physical therapist because I wanted to help patients regain function and
independence. Throughout my clinical practice, I had the privilege of seeing the difference I
could make in individual lives. As my career progressed, however, my perspective changed. I
realized I could create an even greater impact by improving the systems that support patient care.
I often describe that realization by saying, “I began to see the system itself as the patient.” That
shift fundamentally changed how I viewed leadership. Rather than focusing on one patient at a
time, I became interested in improving processes, removing barriers, and helping teams deliver
better care across an entire organization. Opportunities to serve as a union chapter president and
later as a performance improvement coordinator reinforced how meaningful system-level
improvements can be for both patients and caregivers.
What was the most pivotal decision or risk you took in moving toward executive
leadership?
One of the biggest risks I took was accepting responsibility for rehabilitation teams across
multiple facilities where I knew very little about the operations or culture. It would have been
easy to believe that I needed to arrive with all the answers. Instead, I spent my first-year
listening, learning, asking questions, and building relationships.
That experience taught me what servant leadership truly means. Leadership isn’t about
demonstrating that you’re the smartest person in the room. It’s about creating an environment
where people feel heard, respected, and supported so they can perform at their best. That lesson
continues to influence every leadership role I’ve held since.
What aspects of your clinical background were undervalued—or misunderstood?
People often underestimate how well physical therapy prepares someone for executive
leadership. Every day as therapists, we observe, assess, adapt, and communicate while helping
patients navigate uncertainty. Those same skills are essential in executive leadership.
Clinical practice also teaches you to remain calm, think critically, and adjust your approach as
new information becomes available. Those abilities translate directly to organizational
leadership, where every decision requires balancing people, processes, and outcomes while
bringing diverse stakeholders together around common goals.
What advice would you give emerging leaders from nontraditional clinical backgrounds?
Believe in yourself and focus on bringing value wherever you have the opportunity to serve.
Continue learning, remain humble, and invest in relationships. Leadership isn’t about knowing
everything, it’s about helping others succeed while never losing sight of why we entered
healthcare in the first place.
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Ruben Valencia, PsyD, MBA
Associate Chief Administrative Officer, Kaiser Permanente
Dr. Ruben Valencia serves as Associate Chief Administrative Officer for Kaiser Permanente’s
Diablo Service Area, where he oversees medical specialty departments for the largest service
area in Northern California. A licensed clinical psychologist by training, he has built his
leadership career by combining behavioral science, operational strategy, and a commitment to
developing people and improving healthcare systems.
What was your original clinical discipline, and what drew you to it?
I trained as a licensed clinical psychologist because, from an early age, I was inspired by the
opportunity to help people in need. Early in my career, I worked with underserved populations in
correctional healthcare, where I developed a deep appreciation for service, resilience, and the
importance of effective systems of care.
Many of the leadership values I rely on today, however, were developed long before I entered
healthcare. Through sports, I learned the importance of teamwork, accountability, putting the
team’s needs ahead of my own, and celebrating the success of others. Those lessons consistently
positioned me as a leader, regardless of my title, and have remained central to my leadership
philosophy throughout my career.
What was the most pivotal decision or risk you took in moving toward executive
leadership?
Building strong relationships has been one of the most important factors in my career.
Mentorship doesn’t always come from formal mentors, it often comes from colleagues, leaders,
and unexpected opportunities if you’re willing to learn.
The biggest turning points in my career came from stepping outside my comfort zone by
changing organizations and accepting responsibilities beyond my technical expertise. I
intentionally surrounded myself with people who thought differently, particularly from the
business side of healthcare, and ultimately pursued an MBA to strengthen my understanding of
healthcare operations. Learning to challenge my own assumptions—and my imposter
syndrome—helped me recognize the value of my transferable leadership skills and gave me the
confidence to continue growing.
What aspects of your clinical background were undervalued—or misunderstood?
People often underestimate how well clinical psychology prepares someone for executive
leadership. Communication, systems thinking, problem solving, and understanding people
translate directly to leading organizations.
Throughout my career, one of my greatest strengths has been building relationships. Whether
collaborating with patients or executive teams, remaining calm during uncertainty,
communicating a compelling vision, and ensuring people feel heard and valued are leadership
skills that transcend any clinical discipline. Those same qualities have become some of the most
valuable tools I bring into the executive suite.
What advice would you give emerging leaders from nontraditional clinical backgrounds?
Focus on adding value wherever you are. Regardless of your discipline, consistently contributing
meaningful solutions creates opportunities for advancement.
Invest in relationships, seek honest feedback, and intentionally close your knowledge gaps. Set
aside your ego, remain curious, and demonstrate a commitment to continuous growth. Those
qualities build trust, strengthen credibility, and prepare you for leadership long before you hold
an executive title.
Healthcare needs leaders who bring different perspectives to solving increasingly complex
challenges. As David Snyder and Dr. Ruben Valencia demonstrate, executive leadership is not
defined by a single clinical pathway, but by a commitment to continuous learning, collaboration,
and service. Whether the journey begins in rehabilitation, behavioral health, nursing, pharmacy,
laboratory medicine, or another healthcare profession, the ability to translate clinical experience
into strategic leadership has never been more important.
When clinicians learn to think beyond individual patients and begin improving the systems
that serve them, they become catalysts for transformation across healthcare