Chief medical officers (CMOs) lead many initiatives that have a direct impact on the value proposition, such as those focused on improving quality and the patient experience, integrating with physicians, and designing and implementing electronic health records (EHRs).
Hiring the right individual is of paramount importance in today’s environment. The right hire will greatly accelerate an organization’s success, while the wrong hire could potentially derail strategic goals, including efforts to enhance value.
Finding the Right Fit
Gone are the days of the traditional vice president of medical affairs who “manages” the physicians and the medical staff office. In today’s environment, the ideal CMO is a completely different breed of physician. Oh, and by the way, 50 percent of first-time physician executives fail!
So what is a hospital or health system to do?
To illustrate the challenges involved, consider the experiences of a hypothetical health system that is conducting a national search for a hospital-based CMO for one of its hospitals—say, for a community hospital with 200+ beds. For assistance, the health system hires a nationally recognized executive recruiter that specializes in physician executive searches. To establish expectations, the recruiter informs the health system that the pool of qualified candidates is small because the role of the CMO is evolving very quickly, and many do not have the level of experience required for the position.
The Evolving CMO Role
The recruiter understands that today’s CMO needs a skill set that differs from what CMOs required in the past, because the criteria for these leaders have changed—even in the past few years. The recruiter therefore identifies the following search criteria for the ideal candidate for the health systems open CMO position:
- Has been successful in a previous CMO position in a similar setting, with three to five years' experience
- Has experience in integrated systems, medical groups/physician practice settings, and hospitals
- Is comfortable working beyond the walls of the hospital (particularly if that comfort level is based on experience working with a health plan or significant insight into health plan operations)
- Has experience in effective implementation of population health management, care management across the continuum of care, service lines, evidence-based medicine, EHRs, clinical quality improvement, Lean design, safety science, high-reliability design, outcomes reporting, and physician profiling
- Is able to create centers of excellence in collaboration with physicians, nurses, and other stakeholders
- Has expertise in medical staff affairs, credentialing, peer review, management of difficult physicians, contracting, call coverage issues, and the like
Again, the recruiter suggests that the health system has only a slim hope of finding this candidate. More likely, the health system will find someone with 50 percent of the experience outlined above, and would need to train, coach, and mentor the individual in any of the technical expertise that is missing.
These circumstances point to another set of traits that the health system also should look for in the candidate, which will be even more critical to this individual’s success: leadership competencies. We can train an individual in the technical aspects of the role, but it’s critical that we hire an individual with the appropriate leadership competencies that match the local culture and situation that he or she will enter. Furthermore, a hospital like the one in our case example will likely need a leader with specific competencies relative to the local environment.
Finding the Right Fit
I recently read Developing Physician Leaders for Successful Clinical Integration, a new book by Carson F. Dye and Jacque J. Sokolov, which I highly recommend to anyone involved in selecting, developing, or mentoring physicians who are entering the administrative ranks. Dye, senior vice president of Witt/Kieffer, is one of the nation’s foremost executive recruiters; in particular, he has incredible insight into physician executives. Over many years, he has seen healthcare executives succeed and fail, and he has studied why. He has a true gift for finding the right individual for a good organizational “fit.”
Dye’s study of leadership competencies—the subject of a book he cowrote with Andrew Garman, Exceptional Leadership: 16 Critical Competencies for Healthcare Executives—is essential in today’s environment. “Competencies are a set of professional and personal skills, knowledge, values, and traits that guide a leader’s performance,” he and Garman write in Exceptional Leadership.
They group leadership competencies into four cornerstones:
- Well-cultivated self-awareness (living by personal conviction; emotional intelligence)
- A compelling vision (being visionary; communicating vision; earning loyalty and trust)
- A real way with people (giving feedback; developing teams; mentoring others; exhibiting the ability to listen effectively)
- Masterful execution (building consensus; stimulating creativity; driving results)
In Developing Physician Leaders for Successful Clinical Integration, Dye and Sokolov present the following three scenarios illustrating the need for different competencies for different CMO leadership roles.
At a medium-sized hospital in a noncompetitive market with a mostly independent medical staff organized in a fairly traditional manner, a CMO mostly serves as a liaison with the hospital’s medical staff. The leadership competencies desired would likely focus on truly listening, earning loyalty and trust, and building consensus, with less emphasis on being visionary, communicating vision, or driving results.
A health system comprising six hospitals in two highly competitive markets and several hundred employed physicians with a focus on immediate clinical integration would place greater emphasis on leadership competencies such as being visionary, communicating vision, cultivating adaptability, and building consensus.
A small rural hospital that serves as the only acute care facility in a 50-mile radius, with primarily employed physicians—most under the age of 45—would likely place greater emphasis on the competencies of sincerely listening, giving feedback, mentoring others, developing teams, energizing staff, generating informal power, building consensus, and making decisions effectively.
Making the Right Assessment
In reading Dye’s work, I learned about a common mistake that hospitals and health systems make in evaluating a CMO candidate: We place greater emphasis and weight on “chemistry” and “presentation” when it’s highly recommended that “culture and fit” and “leadership” receive the most focus.
I highly recommend the two books noted in this column. They have been a great help to me as I continue to refine my hiring “batting average.”
John Byrnes, MD, is chief medical officer, Sisters of Charity of Leavenworth Health System, Denver, and a member of HFMA’s Colorado Chapter.
Publication Date: Thursday, August 01, 2013