Interim CEOs can be more than placeholders
After 31 years in rural healthcare administration, the thought of retirement was appealing. I was ready when it happened on July 1, 2005. The first few months were great, however, I found I was getting bored as time went on. After a year, I did substitute teaching, kindergarten through high school. Although it helped, it did not fill the void. It was at that point I decided to become an interim CEO.
The role of an interim CEO is not defined, so I figured I would use my talents according to the challenge, whatever it was. During my career, I have been a director of comprehensive health planning for six rural counties; a hospital administrator of facilities that included attached nursing homes, home-health agencies, hospice, alcohol detoxification unit, wellness programs, geriatric psychiatric unit, ambulance service and attached clinics; a consultant regarding community-based health plans; and a consultant involved in closing a rural hospital.
I have worked as a CEO in free-standing, owned and managed hospitals. Because of my diversified experience, I felt I had a lot to offer. I was ready. I updated my resume and mailed copies to recruitment companies, hospital systems, management companies, hospital consortiums and state hospital associations.
It was almost a year before I received my first call. It was from a critical-access hospital in a western state with an attached nursing home, home health, hospice, ambulance service and clinics. They needed an interim CEO with a nursing home license immediately until the CEO they hired would arrive in 6½ weeks. An issue arose regarding the new hire, and I ended up staying 5½ months.
During that time, it became apparent significant changes needed to be made. The issues were discussed with appropriate managers, physicians and hospital board and were implemented. The results improved efficiency, discipline, appearance of facility, staffing issues, expansion of services and morale. Shortly after that, I accepted two additional assignments for critical-access hospitals in the Midwest, where I ended up closing two obstetrical units and made staff changes improving efficiency. In the process, I was able to improve services, add new ones or do both.
Several facts became apparent during the past two years. An outsider has the benefit of being objective. An interim CEO can make decisions that could be career-ending for a full-time CEO.
After the decisions and changes have been made by an interim CEO, the incoming CEO can concentrate on operations. If changes that have a significant impact on a community are to be made, the interim CEO and hospital board should be prepared to deal with the news media. Experience in conflict management and resolution is important. A balanced approach should be maintained in making changes, e.g., look for opportunities to expand and create new services to increase revenue in addition to reducing expenses.
The most important principle is: Be objective. The importance of communication with hospital boards, medical staff, department managers, hospital staff, senior management if a hospital is part of a system, and community during a transition is of significant importance.
I have found that being an interim CEO is rewarding and challenging and not for the faint of heart. One member of a community, who was critical of my involvement in the closing of an obstetrical unit, asked me if I could sleep at night. I said, “Yes,” because I knew that in five years that hospital would still be open.
To some, the role of an interim CEO is to “hold the fort” until a full-time CEO is recruited and in place. Although this is sometimes true, an experienced interim CEO can play a much broader role. With significant challenges facing healthcare facilities, I believe there will be an increasing need for experienced interim or consultant CEOs. For me, age has given me maturity and patience, while experience has provided the tools.
There is life after retirement. John Osse is an independent interim healthcare executive who lives in Casper, Wyo.