by Roger Samuel, Executive Vice President & Practice Leader, MSA Executive Search
In virtually every hospital or health system CEO search that I’ve been involved with in my search work, there is either an internal candidate aspiring to advance into the top spot, or an external candidate we’re presenting who isn’t a “sitting CEO,” but in our opinion, has what it takes to become one. If these “non-CEO” candidates make their way through the Search Committee interview process, it will inevitably result in a discussion around the Search Committee table about the risk associated in hiring a candidate who’s untested in the CEO role. So, what is that risk?
In addition to having all of the skill sets, leadership qualities and experience necessary to serve as the institution’s top executive—meaning the leadership experience and qualities, the accounting/business/finance acumen, a solid understanding of hospital operations, an encyclopedic knowledge of the current healthcare landscape, and a passion for great patient care—I believe there are four areas that truly distinguish an effective CEO from all other executives:
The ability to work well with a Board of Trustees: This may seem obvious, but it’s a completely different experience to work for a diverse set of personalities than it is to be responsible to a single “boss.” Experience that really helps the non-CEO candidates convince us that they can handle this transition is a track record of high performance in heavily matrixed environments, where the definition of success is a moving target. In other words, we’re looking for effectiveness to “serve many masters.”
A desire to be the external face of the organization: We’ve met many candidates over the years who absolutely love hospital operations, and are visible in every corner of the healthcare enterprise at all hours of the day and night. But when it comes to serving on external boards, speaking to the local Rotary club, being involved in healthcare at the state and national level, and eating the proverbial rubber chicken three nights a week, no thanks. Well, guess what? You’re not going to enjoy being a CEO because you can’t escape—and frankly shouldn’t delegate—this vital part of the job. There are some extremely effective “internal leaders” who are just that—invaluable resources to their organizations, known for “keeping the trains running on time. We just don’t recommend you aspire to the CEO role if you don’t love the external part of the work as well.
The ability to deal with medical staff issues 24/7: As anyone who works in healthcare knows, physicians have a proclivity to go to the top with their issues and concerns. The successful CEO goes beyond just grudgingly accepting this as part of the job. If you truly embrace your interactions with physicians—good and bad—you may just have the stuff to be a good CEO.
A “the buck stops here” mentality: A good friend and mentor who just retired as the CEO of an academic medical center after an illustrious career once told me he was paid to make only a few decisions a year—but they were the tough ones to make. You likely didn’t get this far in your career without developing an ability to build consensus and make good decisions. But to this point you’ve always had the CEO to go to when called upon to make that particularly difficult or controversial decision. In this regard, a good CEO is a bit like the 9th inning closer in baseball—it’s that “give me the ball” attitude we’re looking for!
If you ever get to the point of being in an interview for a CEO role with one of our consultants, you can expect a line of questions that tries to get to your both your readiness for and a desire to do the work articulated above. What we want to make sure of is, do you want the work or do you want the title?