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Rise of the Chief Strategy Officer

Philip Betbeze, for HealthLeaders Media, November 25, 2013

While the CEO is still ultimately responsible for strategic direction, increasingly, health systems are creating the position of chief strategy officer, who guides the planning, execution, communication, and sustainment of that strategy.

This article appears in the November issue of HealthLeaders magazine.

As healthcare undergoes seismic shifts in its business model, many healthcare CEOs have realized they need help on the executive team. Increasingly, that help is coming in the form of leaders who can focus exclusively on something that in many organizations has been the CEO's exclusive responsibility: long-term strategy.

While the CEO is still ultimately responsible for strategic direction and follow-through, increasingly, health systems are creating the position of chief strategy officer, a person who guides strategic planning and is responsible for executing, communicating, and sustaining that strategy. Think of them as business development gurus who are generalists; their projects are long-term in nature. That's one reason a good CSO is hard to find and often will come from within the organization: The right person will need to possess well-rounded knowledge of how the organization functions now in order to envision a higher-functioning future state.

Despite the benefits of the inside candidate, many experts suggest that the chief strategy officer role may be a good fit for executives who are making the transition to healthcare from other industries, given the importance of fresh thinking, strategy, business development, and marketing that is central to the CSO's role. Many systems, however, are reluctant to take that risk.

Significantly more challenging

Greg Poulsen got involved with strategy work at Salt Lake City's Intermountain Healthcare 18 years ago—already 12 years into his career at the 22-hospital system. Then, he was the senior vice president of planning. In part due to his longevity with the organization, he was uniquely qualified because of a reasonably broad understanding of what works and what doesn't, he says. Now, as the CSO for the past five years, he's been elevated to the C-suite—a tight circle of advisors close to the CEO. He attributes that not to his own expertise necessarily, but to the dramatic shifts in the way healthcare business is conducted and the need for health systems to adapt to that change.

"The thing that's changed the most over the past five years that has elevated strategy work is the rapidity with which the world around us is changing," he says, adding that not all of the changes are positive. "Some of it is purposeful change in a consistent direction, but much is turbulent in that it goes one way one day and another the next, and figuring out the correct path is significantly more challenging than when I started."

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2 comments on "Rise of the Chief Strategy Officer"


Dike Drummond MD (11/29/2013 at 2:32 PM)
Chief strategy officer from outside of healthcare ... that is just one more member of the C-suite that has no concept of the stresses of the front line providers. With physician burnout rates at an average of 1 in 3 on any given office day regardless of specialty ... and the CSO clueless about what it takes to see patients ... my fear is they will recommend profit goosing moves that simply add to the stress on the doctors and nurses ... then scratch their head and wonder what is wrong with those people. If the CSO brings the mantra that exists in so many other industries - you know, this one: "We hire the best people we can find and take really good care of them" ... they might do some good. If they are just another clueless business mind that thinks healthcare is identical to running a manufacturing business [INVALID]- let's just make sure the current C-suite actually does some strategic planning twice a year. My two cents, Dike Dike Drummond MD TheHappyMD (dot) com

Donald G. Bellefeuille (11/25/2013 at 1:29 PM)
We've all been seeing more and more positions posted for Chief Strategy Officers. On the face of it I should welcome this recognition of the importance of our discipline in healthcare. But I just can't bring myself to do it. I argue in my blog,The StratEx Crossroad: Where Healthcare Strategy and Execution Meet, that our profession has to become more involved in the execution side of the equation. And that's what I don't see in a Chief Strategy Officer. By placing strategy at the center of the title and assigning chief to it you have essentially eliminated any possibility of getting involved in execution. Because any person in this role will want to maximize the amount of strategy they do, right? It's only natural because they are the Chief. And doing a lot of strategy means you are doing next to no execution. Then there is the problem of all the other chiefs popping up: operating, marketing, technology/information, medical, development, etc. How's that cliché go? Too many chiefs spoil something or other. So what is a poor Chief Executive Officer supposed to do? He is a Chief and, presumably, the head chief and execution is part of his title. So who is the Chief Strategic Execution Officer then? The CEO, the CSO, the COO? Who is the chief if everyone is a chief? I said in a previous post (Reorganization Is the Last Thing You Should Do) that the work should determine how you organize. And it's still good advice. The plethora of CSO postings sounds like just the opposite: That organizations are re-organizing themselves before they even know what the work in the new era of health reform entails. So be careful what you wish for as a Chief Strategy Officer. You may find yourself wanting more control over execution because when execution goes badly strategy gets blamed.