"We have a lot of bright young people coming out of graduate programs that are not getting the same opportunities that people had 20 years ago," she says. "It used to be that 20 years ago you could walk into an assistance administrative role and essentially be in the C-Suite in some role. Now you are lucky to get a director-level position for one department."
Genser says most current CEOs were younger than 35 when they landed their first leadership jobs. "If you look now at the number of people who are CEOs under 35 it is a very small number," she says. "In that time, I will grant you, healthcare has become more complex. But I also think people are reluctant to give those responsibilities to younger people as fast as they were given them themselves."
In addition, she says, the consolidation of the hospital sector is "radically" changing the role of the C-Suite and that could make it harder to find well-rounded and experienced senior leadership in the coming years.
"For example a hospital finance position, which before had responsibility for debt and treasury and bond issuances and even revenue cycle, may be part of a system now where all of those things are corporate," she says. "So, in some functional areas there is going to be a shortage, particularly of independent CFOs who can go the whole gamut."
"That is true even for CEOs who are probably called presidents in some of these systems. They are really more like operating officers," Genser says. "We are seeing a shift in the whole dynamic of organizational structures and where that is going. There will always be good talent. The question is can you attract it based on how you are structured if you need to go outside your organization? Or, can you grow and build it and develop it inside your own organization?"