REVIEWED BY PETER J. GIAMMALVO, PhD
Scott Ransom, ed.
American College of Physician Executives, Tampa, FL, 216 pp., 2003, $35 (members),
$45 (nonmembers)
In the preface, Scott Ransom, DO, the editor of this book, summarizes the many
and varied challenges currently facing leaders of health care organizations.
It is clear that responding to these challenges will not only require strong
and competent leaders, but also that these leaders will require new or revitalized
competencies to lead successfully. Moreover, simply responding to challenges
will not be sufficient. Leaders will be required to participate actively in
setting the health care agenda, both nationwide — especially in areas such
as public policy — and in their own communities and organizations.
In this book, Dr. Ransom has assembled the perspectives of a number of knowledgeable
and experienced health care leaders, consultants, executive recruiters, and
academics. They offer varied approaches on how to address the critical issues
outlined in the preface, as well as advice on how to become a successful CEO
in these challenging times. With CEO turnover rates continuing at record high
levels, the assembled wisdom in this book may provide some practical assistance
both for incumbents and for those who aspire to the role of health care organization
CEO.
In the very design of this book, the author provides a fundamental insight
into the role of the CEO: It is complex and multifaceted. No single perspective
will capture the essence of what is required of this position. Physician leaders
bring unique insights; leaders of university medical centers add another perspective;
and academicians and consultants have the benefit of some objective distance
and results of research. Rural hospitals present one set of challenges; large
urban medical centers a different set of issues; systems may offer a combination
of leadership challenges; and, of course, there are unique systems like the
Veterans Health Administration.
The reader may glean pearls of wisdom from all of the contributors. Not all
pearls will be as valuable as others. In many ways, the beauty may be in the
eye of the beholder. That is, what a reader may gain from this book will be
heavily dependent upon what he or she is searching for. For example, chapter
1 offers excellent information about "CEO thinking." This is a perspective
especially useful for the high-potential "up and comer" who may be
in a functional lead role at present but desires a broader leadership role in
the future.
On another level, there may be a question of the culture or organizational
setting in which one practices. Some may even use the language of vocation,
or of the mission or ministry to which one is called. Several authors offer
perspectives concerning the business leadership competencies required of CEOs.
For example, there are competency profiles of "growth" CEOs and "turn-around"
CEOs. Although these are valid perspectives, they may leave out a dimension
fundamental to leaders of faith-based organizations such as Catholic hospitals.
Leaders of organizations that provide preferential service to those who are
poor and underserved may require a different set of competencies and decision-making
priorities. In many cases, the CEOs of such organizations will see their roles
as leaders of a ministry.
In the chapter on how to recruit a top health care CEO, the author, Michael
Doody, quotes Sr. Mary Roch Rocklage, RSM, a former CEO and current chair of
the Sisters of Mercy Health System, St. Louis. She refers to the role of the
CEO as that of a builder or "rebuilder" of the connectedness that
has been lost in many health care organizations, especially as different factions
try to go their own way and lose sight of the singular mission and unifying
vision to which they are ostensibly committed (p. 40).
In saying this, I do not mean to minimize the viewpoint of those contributors
who emphasize the critical importance of business discipline in the CEO role.
After reading this book, it is clear to me that the successful CEO will not
be the person who falls victim to the tyranny of the "or." Instead,
he or she will be the advocate and agent of the critical necessity of the "and."
Success will never be achieved through the application of business and financial
acumen alone, on one hand, or visionary thinking alone, on the other.
The wisdom offered in The Wisdom of Top Health Care CEOs may be simply
stated, but it is very complex in its application. The health care organization
of the early 21st century is one of the most complex social structures in our
country. It serves human beings at the most vulnerable and life-threatening
(and life-giving) times in their lives. Such an organization is staffed by a
multitude of highly skilled — often highly specialized professionals — some
of whom (e.g., physicians), although not employed by the organization, nevertheless
control the allocation of many of its resources. Add to the mix the nature of
the reimbursement systems that finance health care (the federal government being
the largest) and the varied ownership/sponsorship models, and you have the makings
of one of the most challenging CEO roles in any industry.
Even so, many people are seeking this role. Some are called to this
ministry. More are needed, and they must be well prepared. To those already
on the journey and those still considering health care as a career path, this
book speaks volumes.
Peter J. Giammalvo, PhD
Vice President, Leadership Formation
Catholic Health East
Newtown Square, PA