The delivery of healthcare in the US is terrible right now. Nurses and physicians have been the backbone of healthcare for centuries. Physicians are perfectly placed to be the leaders, not only in the clinical side but also in the delivery and management of healthcare. Read on to find out why.

This is the first of a three part series looking at why physicians should be CEOs in healthcare.

Here are links to the other posts:

Why We Need More Physicians as CEOs in Healthcare- Part 2: Defining Physicians

Why We Need More Physicians as CEOs in Healthcare- Part 3: Conclusion

Where is American Healthcare?

The delivery of American Healthcare is not in a good place. I’ve written about this before:

Health Care in America 101: Part 1- Why is it F#cked Up?

Health Care in America 101: Part 2- Who Pulls The Strings?

Health Care in America 101: Part 3- How Are We Ripped Off?

Health Care in America 101: Part 4- The Way Forward

We are not in a good place. We have dedicated physicians, nurses, techs, APPs etc etc and are the home of groundbreaking clinical research and yet we struggle to not bankrupt patients, struggle for transparency and struggle to provide value.

American healthcare provides good quality but poor value:

Something has to change, because the current models are not working:

What Does a CEO Do?

The Chief Executive Officer (CEO) of a hospital/company/health system is responsible for execution of the mission and vision of his/her organization.

The mission statement is the core values and purpose.

The vision statement are the future-facing goals and ambitions of an organization.

Note that the CEO probably affects stage 3 and 4. In most organizations the mission and vision have been defined. What may change is the road to get there and the measures of how far the organization gets.

By definition, the CEO is the highest ranking executive in an organization with chief decision-making authority.

The CEO makes decisions that others can’t.

That’s a really important point. The CEO does not make every decision and can’t. If those working with the CEO have expertise in their area the CEO relies on them to make those decisions. When those working with/for the CEO cannot, then the CEO decides.

The CEO is responsible for the strategy to enact the mission and chas the vision and selects the measures to evaluate success. The CEO does not micromanage. The CEO does not fill in when someone is absent. The CEO may not be involved in day-to-day operations.

The CEO focuses on just 3 things:

1. Culture

Culture is how people view where they work- the corporate identity. The CEO oversees, establishes and nurtures behaviors in the company. The CEO sets the example. The best CEOs are often servant leaders- putting the needs of others before their own. They lead by example. The worst are the narcissistic leaders- very charismatic on the surface but ultimately destructive and not fulfilling the mission or furthering an organization towards its mission.

Why We Don’t Need Narcissistic Leaders

There are numerous examples of CEOs that provide good role models to their staff and others where the culture within the organization is allowed to fester. Employees have a view of themselves and then a view of where they work. The CEO sets the tone for this culture. By showing ethical leadership, valuing it’s employees and having transparency in pursuit of its mission statement and ultimately vision the CEO articulates the strategy of success. Making employees believers is the strategy. The employees than enact the mission.

Culture is the environment we work in. This includes its beliefs, ethics, traditions and rituals that as an organization bind us together.

2. People

As a medical student I thought medicine was about science. As I got older I realized it was about people. The interactions with colleagues, patients, other hospital workers ranging from cleaning staff to the executive team define us and control us. Medicine is an art and it’s about people. We learn the science is imperfect. Things go wrong despite best intentions but as long as we empathize and communicate things turn out ok. The CEO in an organization picks the people around him. Those people should be like-minded in terms of culture and help the CEO further the mission towards the vision. The CEO of a company wants to surround him/herself with people smarter than him/herself but all with specific skill sets and roles. It’s all about people.

 3. Numbers

Medicine is business. Business is money. A large organization employs many people from the CFO down who manages these. The CEO gets to decide which numbers are important (Key Performance Indicators- KPIs) and how often they are assessed all the while keeping the mission and vision in view. Most CEOs do not come from an accounting or finance background.Establishment of these metrics, their feedback to staff and subsequent decisions are in the domain of the CEOs roles.

Conclusion

Pretty simple really. CEOs control the culture and people of an organization and are responsible for defining which numbers (KPIs matter). They make decisions no one else can. They set the tone and direct the strategy for fulfilling the mission statement working towards the vision of the organization.

Next, we will look at physicians. What attributes do they have that can be useful outside a clinical setting?

Why We Need More Physicians as CEOs in Healthcare- Part 2: Defining Physicians

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