Chief Executive in Charge of Nothing

Molly Rowe, for HealthLeaders Media, January 25, 2008

One of the principles of good journalism is name and title verification. Never guess that a source's name is Christine (not Kristine, Cristine, or Krystine); never assume that a company head is CEO (not founder, president, his highness, or something else). It seems like a simple enough rule but as organizations add clever and unusual titles to their org charts, getting the title right has never been so difficult.

I've met the Vice President of Clinical Effectiveness and Efficiency, the Director of Innovation and Bright Ideas, and the Manager of First Impressions since I started writing about healthcare. New and creative titles aren't just reserved for mid-level staff. Even the C-suite has expanded to include other chiefs: the Chief Nursing Officer, the Chief Medical Staff Officer, and, more recently, the Chief Quality Officer.

Baptist Health in South Florida is one system that recently added a CQO to its senior leadership. Although Baptist's always focused on quality, CEO Brian Keeley says his CQO (a former CMO) drives quality at a system-wide level. Keeley calls the decision to add a CQO to the executive suite one of the best decisions he's made. "We should have done this many years ago," Keeley says.

Other titles growing in popularity include proceduralist, transition coach, and Chief Governance Officer. New titles like these reflect the changing landscape of healthcare and some of its biggest focus areas: quality and transparency, the aging population, ED overcrowding, and the increase in board involvement.

Sometimes a new title reflects an organization's individual needs or goals, like the Chief Learning Officer at North Shore Long Island Jewish Health System. With more than 35,000 employees system-wide, NSLIJ's got some serious staff training needs. The CLO heads the Center for Learning and Innovation and oversees its $2-million training budget.

Of course, not all new titles are good ones. In fact, I'd argue that most new titles aren't worth the trouble. When you make someone the manager of first impressions, there's a good chance other employees will want to be "manager" of something, too. Unless a new manager/chief/director actually has resources and staff under them, don't bother with the fancy title.

When you add a new title just to suit an employee's particular skills, you'll need to recreate job descriptions and tailor performance evaluations for no other reason than to fit the new title. And while giving someone a clever new title may increase their job satisfaction today, that alone won't keep them around tomorrow.

So, beware, although new titles do occasionally bring about better business, the addition of one little title could cause big headaches for you, your staff, and yes, journalists like me.

What titles has your organization recently added? Have you created a new position to address a long-term need? Or do you have an existing employee whose skills just demanded a change in name? Drop me an email; I'd love to hear about it.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at
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