Chief of Staff: A Much-Needed “Right Hand” for Healthcare CEOs
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By Andrew P. Chastain

Healthcare CEOs are experiencing an expanding workload as the industry continues to change, making it challenging to “steer the ship while scanning the horizon for threats and opportunities.” It is unrealistic to think that one person can capably juggle all the responsibilities while serving a wide range of constituents. One solution for CEOs is to engage a chief of staff to serve as their “right hand.”

Though common in politics and the corporate world, a chief of staff is relatively new in healthcare. I have recently co-authored two articles on this topic with Andrew Cox, chief of staff at WellStar Health System in Marietta, Georgia: Why a Health Care CEO May Need a Chief of Staff, in the March 2017 issue of Trustee Magazine; and “How to Help a CEO in Need—Hire a Chief of Staff,” in Hospitals & Health Networks. Other media outlets have picked up on the idea as well, as I think it resonates in a time of complexity and change in the industry.

Andrew Chastain

At WellStar, the chief of staff position was established in 2014 to support the transition of then-President/COO Candice Saunders into the CEO role. There, and in other organizations testing the role, the chief of staff is often a “connector” to join the CEO with individuals and ideas across the system. As detailed in the articles, the responsibilities of the chief of staff are broad and varied, depending on the specific needs of the CEO and the organization.

A board or organization that is contemplating a chief of staff to support its CEO should do so with realistic expectations and with consideration of the specific needs of that CEO and of the organization.

In researching this topic, I had the chance to talk to WellStar CEO Candice Saunders about the chief of staff position (currently filled by Andrew Cox) and her thoughts on the importance of rooting the role in trust. A longer version of this Q&A below can be found after the Hospitals & Health Networks article.

What were your main criteria for hiring a chief of staff initially?

Saunders: We discussed a number of criteria in the initial planning stages, but in the end we stayed true to our principle for all leadership positions, which was to hire a leader that possessed both character and competence. I felt that the person who would fill the role would need to possess the skills to create and sustain productive and honest relationships with the executives, physicians, leaders and team members across the organization and in the communities we serve.

How dependent is the success of a chief of staff on his/her relationship with the CEO?

Saunders: The relationship must be rooted in trust and vision, not based on individual pursuits but based on organizational goals. The trust is particularly important because the chief of staff often acts as a surrogate or representative of the CEO and the organization as a whole. I benefitted from hiring a chief of staff that had been with the organization for a number of years and whom I personally worked with in a previous role. I knew the character and the work ethic of my chief of staff which accelerated the pace for us to build our new relationship.

Do you see your counterparts at other systems wanting and needing this type of role to support their work?

Saunders: This is a role I would recommend for larger health care organizations and my fellow CEOs. Larger health systems are large social systems that feature a number of communities, hospitals, care sites, physicians, leaders and team members. In large organizations, communication is essential and the chief of staff acts as a connector between the CEO and every aspect of the organization.

Andrew P. Chastain is Witt/Kieffer CEO. 

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