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This is a blog post about career management for healthcare CFOs.  Really it is.  But to get to the point I want to make on career management I need to, once again, plow through the issues of improving quality of care, making care safer, reducing costs and enhancing patient satisfaction.

CFO's career strategyIf you pay attention to the issue of patient safety and improved quality, you know that the agitated push and pull regarding recent studies concerning preventable deaths has escalated.  In one post, a distinguished but defensive academic physician doubted the extent of the problem because, he said, these studies are too small, too anecdotal, and too flawed in their methodology.  In other words, if you do not agree with the problem that is being presented, or you are concerned about the impact of these studies on the practice of medicine, you question the data.  It is a timeless argument.

On one side, you have legions of quality of care and patient safety experts who say the problem is bigger than any of us want to imagine.  On the other side, there is a theme in the writings of those who want to disagree with this belief — the doubters, definitely in the minority, who usually acknowledge that there is a problem but immediately question the validity (the data) of any study regarding the magnitude of the problem.  Their rationale is almost always structured as:  yes, we have a problem with quality and safety but it is doubtful that it is really that big a problem.

So, this brings me to the career management side of this post.  I recently completed interviews with dozens of hospital CFOs.  We focused on two issues:

  • Whether mergers/consolidations will improve performance of healthcare organizations
  • What the role of the CFO is in enhancing quality, safety and patient satisfaction while reducing costs

These were interesting conversations, but not for the obvious reasons.

On the first subject — health system consolidation — the overwhelming majority of CFOs laughed when asked whether mergers would help reduce costs, improve quality, enhance safety and make the patients happier.   Here is a sample of their candid remarks:

  • “Not in our lifetime,”
  • “I cannot think of any healthcare merger that produced any of those benefits. It was usually the opposite.”
  • ”This rush to consolidation is all a fad, smoke and mirrors — strategies we trot out every 10 to 15 years when we are not sure what to do with market changes or reform…”
  • “Healthcare is a local enterprise.  We went through this before and it did not work because larger systems never achieved all the financial synergies that were used to justify the deal to begin with.”
  • “Higher corporate overhead at the system level will drive up costs, losses will follow and, in the end, we will pay consultants a boat load of money to unwind our mistakes, yet again.”
  • “The theory is understandable but it is questionable whether these expanding systems have the wherewithal — the leadership experience or in some cases the political will in the face of opposition from their affiliates —  to achieve the kind of results that would justify the effort.”

But here is the more important point: when the conversation shifted to quality of care, patient safety and improving patient satisfaction, these CFOs were “all in.”  Every CFO I spoke with had something meaningful to say about the critical importance of their role in dealing with those issues.  There was one health system financial CFO who offered the most poignant assessment:

“Our patients, their safety, their well-being after they go home — whether they got better or if they had to be readmitted — is deeply important to me and other members of our senior leadership team. Isn’t this why we all got into healthcare in the first place?

“My job is to help the caregivers, the clinicians and support staff, with strategies and tactics to achieve these important objectives.  I can’t be the grinch who is only focused on saying ‘No.’  I have to find a way for us to be better clinically, in safety and with service.  I cannot sit on the sideline and count beans and complain about expenses.”

How is this CFO different from his colleagues?

He has been a CFO, a COO and CEO.  But more importantly, he has been a patient advocate for a critically ill sister.  That proved to be an eye-opening,  life and career changing moment.

“We think we know what goes on in our hospitals, but we don’t. It is appalling.   I have always believed that America had the best healthcare in the world but when you see it from the patient’s perspective, when you see the breakdown in coordination, the medical errors, the problems with hospital infections, the near fatal misses, it shakes you to your very core.  I had no idea of the hidden problems in the delivery of  quality safe care that exists in most hospitals in America.

“As a CFO, my role in helping correct these problems is just as important as that of the Chief Medical Officer, Chief Nursing Officer or the quality department… I have asked to be more involved in this side of the business so I can be a better resource for my colleagues.”

For a CFO’s career brand, this point of view is a game changer.