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Physician-scientists represent one of the most impactful, yet underrecognized, innovations of 20th century academic medicine. Defined by a commitment to full-time careers in investigative work, physician-scientists have repeatedly demonstrated a unique ability to identify and solve problems of unmet medical need in a focused and intentional manner using their dual training in clinical medicine and the scientific method as both stethoscope and scalpel. Unfortunately, while the value of physician-scientists has never been greater, the institutional infrastructure to support them has never been explicitly defined (1), a deficiency now amplified by mounting financial pressures from both clinical revenue models and an increasingly constrained research funding landscape (2, 3). This white paper reports the output of a consortium of academic medical centers, foundations, and professional societies seeking to remedy this deficiency. This consortium specifically developed a framework to formalize the career path of physician-scientist faculty into a professionally unified and financially sustainable structure amenable to adoption across US academic medical centers and health systems. Key components of this framework included an administratively operational definition of physician-scientists, and 3 central and interconnected pillars (academic, financial, and organizational) that are rooted in this foundational definition. Herein, we detail core concepts and concrete recommendations.