Case Summary

P H Y S I C I A N L E A D E R S H I P

How to Find the Ideal Chief Medical Officer

John Byrnes, MD, president and CEO, Byrnes Group LLC, Ada, Michigan

H ave you ever hired the wrong physician executive—a physician who was well respected and a superb clinician, but for some reason failed as a leader? We have probably all been there. Unfortunately, this problem is all too common.

The fallout from bad hiring decisions can be costly. A failed hire costs hospitals and healthcare systems not only the fee paid to the executive recruiter but also severance pay (in many cases) and the expense of hiring a replacement. The total cost can be well over $500,000 for a typical chief medical officer (CMO). Healthcare leaders need to do everything possible to avoid these mistakes.

So how do we select highly effective physician executives who will be successful leaders in our organizations?

M Y F O R M U L A F O R S U C C E S S I have been a system CMO twice. In one of these positions, I was responsible for hiring CMOs for three hospitals across the healthcare system. Each hospital was unique, not only in culture but also in size and geographic location. A CMO who would be perfect for one hospital might not be successful in another. Hiring three CMOs with distinctive skill sets that matched the organizations' needs was no small feat.

If you are in a similar position, I recommend three steps: (1) partner with leadership to appoint a selection committee, (2) have the selection committee read relevant literature, and (3) retain an experienced executive recruiter.

P a r t n e r W i t h L e a d e r s h i p t o A p p o i n t a S e l e c t i o n C o m m i t t e e As a system CMO seeking to hire three hospital CMOs, I first partnered with the CEO and other members of the C-suite at each hospital to appoint a selection committee at the local site. Each committee was made up of C-suite executives and physician leaders from throughout the hospital. Everyone on the committee had input during the selection process, but the hospital CEO had the final word.

H a v e t h e S e l e c t i o n C o m m i t t e e R e a d R e l e v a n t L i t e r a t u r e Selection committee members should read books and articles about physician leadership. Everyone on my health system's selection committees read two books. Developing Physician Leaders for Successful Clinical Integration (Dye & Sokolov, 2013) contains valuable advice on selecting, developing, and mentoring physician leaders.

311

Journal of H ealthcare M anagement 6 1 :5 S eptember/ O ctober 2 0 1 6

It was perfect for our situation. The second book, Exceptional Leadership: 16 Critical Competencies for Healthcare Executives (Dye & Garman, 2015), is a review of the essential leadership competencies for healthcare executives. Dye and Garman (2015, xiii) define competencies as "a set of professional and personal skills, knowledge, values, and traits that guide a leaders performance." The selection committees found both books to be good refreshers for executives with considerable hiring experience and useful introductions for those hiring their first CMO.

The selection committees focused on four groups of sought-after leadership competencies (Dye & Garman, 2015):

• Well-cultivated self-awareness (leading with conviction, using emotional intelligence)

• Compelling vision (developing vision, communicating vision, earning trust and loyalty)

• A real way with people (e.g., listening like you mean it, giving great feedback, mentoring, developing high-performing teams)

• Masterful execution (e.g., building true consensus, driving results, stimulating creativity, cultivating adaptability)

The selection committees then combined these competencies with a key lesson described in Developing Physician Leaders for Successful Clinical Integration (Dye & Sokolov, 2013). As noted earlier, CMO roles can differ greatly in terms of the skills and competencies needed for success. These three scenarios illustrate the competen­ cies needed for various CMO roles:

• A medium-sized hospital in a noncompetitive market is organized in a fairly traditional manner. The CMO serves as a liaison with the hospital's mostly independent medical staff. The leadership competencies likely to receive greater emphasis are listening like you mean it, earning loyalty and tmst, and building consensus; of less significance are being visionary, communicating vision, and driving results.

• A health system comprising six hospitals in two highly competitive markets with several hundred employed physicians and immediate plans for significant clinical integration likely would place greater emphasis on 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 employed physicians mostly younger than 45, would likely place greater emphasis on the leadership competencies of listening like you mean it, giving feedback, mentoring others, developing teams, energizing staff, generat­ ing informal power, and building consensus.

The selection committees with which I worked used this insight to identify key competencies needed for each of the three hospitals in the system. We also learned to avoid one of the most common hiring mistakes—placing undue emphasis on

3 1 2

P hysician Leadership

chemistry and presentation when, according to Dye and Sokolov (2013), culture/fit and leadership should be the focus of attention.

R e t a i n a n E x p e r i e n c e d E x e c u t i v e R e c r u i t e r The third step in finding the right CMO is retaining a highly respected and successful executive recruiter with extensive experience recruiting physician executives. CMO searches can be particularly difficult because the pool of available and qualified candidates is limited and a high percentage of first-time physician executives fail. The recruiter should have exceptional insight in how to hire physician executives who will succeed—as well as a huge file of potential candidates.

F I N A L T H O U G H T S Hiring a CMO who will succeed in an organization with a unique culture is not an easy task. Many of us default to internal candidates because they already know the culture. Sometimes this is the right way to go. At other times, bringing in someone from the outside is best: an individual with a variety of experiences in different organizations and a successful track record in similar positions. I have hired CMOs both internally and externally, and succeeded and failed with both approaches. However, the last time I batted 1.000 was when I used the three steps described here.

R E F E R E N C E S Dye, C. F„ & Garman, A. N. (2015). Exceptional leadership: 16 critical competencies fo r healthcare

executives. Chicago, IL: Health Administration Press. Dye, C. F., & Sokolov, J. J. (2013). Developing physician leaders fo r successful clinical integration.

Chicago, IL: Health Administration Press.

For more information about the concepts in this column, contact Dr. Byrnes at john@johnbyrnesmd.org.

313

Copyright of Journal of Healthcare Management is the property of American College of Healthcare Executives and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.