Organizations didn't always seek out doctors for this top post. The CEO role requires someone with financial acumen and strategic, big-picture vision willing to focus significant energy on administrative work—not characteristics associated with the job of a typical doctor, says John Frantz, president of The Sutton Companies (a property development, management, and brokerage firm) and a board member for the 506-bed Crouse Hospital, both in Syracuse, NY. "Ordinarily they're not trained to think of themselves as managers or administrators," he says. "They're trained to think of themselves as clinicians. The job is an administrative job." And in all but the rare circumstance, it leaves little opportunity to see patients regularly.
What made physicians suddenly ideal for the post? Bolster credits the release of the 1999 Institute of Medicine report, To Err is Human, coupled with an industrywide shift from the vice president of medical affairs job to the chief medical officer role. As the CMO position developed into a regular part of the C-suite, it became a springboard for physicians to move into the CEO job, allowing them to sidestep a more traditional move-up-the-ranks path, he adds. With these changes, organizations began making the doctor-as-administrator connection.
Even with this shift, breaking into hospital administration isn't hurdle-free for a physician with an atypical trajectory, Hochman says. He understands this well; before becoming a hospital CEO, he was a CMO. "People thought, 'He's a doctor. He's coming in. He thinks he is privileged because he's a doctor.' Some of the nonclinical administration folks kind of look at you with some element of apprehension," he says. "Until they realize you're not a typical doctor."
The MD CEO leg up
Ironically, the thing that sometimes makes nonclinical administration nervous about a doctor as head honcho—the MD credential and all its associated parts—gives the physician CEO an automatic in with hospital staff, especially other physicians. This is crucial in today's healthcare environment.