Welcome to the Lattice: Charting a New Course to the Healthcare C-Suite
Years ago the route to the C-suite in healthcare was fairly predictable – a step-by-step ascent up the ladder to a top job in operations,...
By Jason Petros and Keshia Harris
Years ago the route to the C-suite in healthcare was fairly predictable – a step-by-step ascent up the ladder to a top job in operations, finance, human resources, or whatever one’s chosen area of expertise happened to be. Climb enough rungs and one might even land in the top spot, as CEO.
That was then. Today, healthcare organizations have transformed from primarily standalone, hierarchical community hospitals toward sprawling, complex regional and even national mega-systems with a myriad of facilities, functions, and service lines. This is due to a variety of factors, especially market dynamics which have prompted organizations to expand their offerings and grow their footprints (typically through mergers and acquisitions) to serve more patients and communities, thereby driving new revenues and creating cost and resource efficiencies. As a result, today’s systems require the executive team to “shift away from the ‘individual expert’ model . . . and move towards a model that leverages cross-boundary groups and teams and spans disciplines, levels, functions, generations, and professions.”
Executives Have Options
Executive career advancement in highly matrixed organizations – whether within one’s own organization or across many employers (and even multiple industries) – often means moving sideways or diagonally rather than upward. As a result, many talent experts refer to a career lattice rather than a ladder.
Take the example of Tammy Scarborough, current Chief Administrative Officer and President of the Statewide Region of UNC Health. Among her duties, Scarborough oversees acute, outpatient, and ambulatory operations of 14 network hospitals across North Carolina.
Scarborough’s path to her current position was a circuitous one which took her through fields as diverse as real estate, investment banking, IT, higher education, and business consulting. Her healthcare career started in finance within an academic physician group. She then moved to community healthcare leading ambulatory and ancillary service lines, later transitioning to a focus on acute care. Eventually she moved into regional operations management, which ultimately led her to her current role with UNC Health.
Such a career path might seem random and unplanned. But for Scarborough every stop afforded her the opportunity to gain valuable experience in unique settings. Along her career journey she made intentional, strategic decisions to enhance her knowledge, skills, marketability, and future options.
Contrast Scarborough’s experience with that of Gabrielle Cummings, FACHE, President of the newly created Endeavor Health, an Illinois-based conglomeration of nine regional hospitals and 300 care locations. Cummings’ career is a study in what a lattice-oriented approach can look like when applied primarily within one organization over many years – for her, 21 to be exact. After beginning in the insurance field specializing in medical malpractice underwriting, she transitioned into administration through a post-grad fellowship at NorthShore University Health System (now Endeavor). She has remained with the organization since, rising to lead Highland Park Hospital before moving diagonally to greater roles within the system. As the organization has grown, opportunities have opened up for Cummings which didn’t exist when she first signed on two decades ago.
Cummings was intentional about finding opportunities to grow in an increasingly matrixed organization. This strategy involved taking on projects which, on the surface, seemed less exciting or immediately beneficial than other options. But the projects increased her knowledge and visibility in other areas of the organization and helped build new relationships. One initiative resulted in her being one of the few leaders who knew how to implement a network-wide technology platform. This unique experience catapulted her to her current role. Like Scarborough, Cummings learned to embrace the lattice concept and use it to her career advantage.
A New Leadership Landscape
In the lattice, success is no longer about reaching the next rung but about taking on roles and responsibilities which provide opportunities for growth and fulfillment, and which continue to pay dividends (including, one hopes, greater compensation) as one accumulates valuable experiences in early-, mid-, and late-career stages. Let’s consider some of the defining characteristics of this new executive career landscape:
- The lattice favors those who take risks and invest in themselves. As Scarborough, Cummings, and other executives in the lattice environment learn, getting where you want to go requires creativity and both vertical and horizontal moves. (A step down might even be in order to fill a skills gap in, say, finance or technology.) Successful lattice navigators, rather than striving for specific titles, seek to build skills portfolios that align not only with today’s challenges but that also anticipate needs of an organization and the healthcare ecosystem five to ten years from now. The key is to take a few risks to better oneself. “Lighting your career path means there will be places that are dark,” Cummings says. “If you take steps to move out of your comfort zone, you’ll realize you had the resources to do it all along.” Growth may require changing organizations and industries. Executives escape their comfort zones by encountering different people and situations and adapting to new environments. Time spent in a new setting – a nonprofit healthcare executive moving to a for-profit company, for instance – can open
one’s eyes to new ways of working and leading. Time spent in other sectors provides invaluable insights and experiences to compare and contrast against those in a healthcare industry. - Executive roles are emerging and evolving. Larger, more complex systems have spurred the creation of new executive roles – service line leadership as well as, for example, titles like chief transformation officer, chief digital officer, and chief patient experience officer – and broadened traditional roles like President, CFO, and Chief Medical Officer. As healthcare shifts to a more consumer-oriented, omnichannel environment, more and more positions will be focused on what’s happening outside the hospital and clinics. From an executive career perspective, new opportunities will continue to appear. It makes little sense, therefore, to target one specific role or title as it may vary from one organization to another and may require different skills a few years down the line.
- Specialization has increased. As more strategic roles consolidate at the system level, we’re seeing more specialization across the board with a focus on impact. Human resources is being refined into positions responsible for total rewards, learning and development, and HR strategy. Finance is drilling down to the treasurer, revenue cycle, and controller levels. And so on. This would seem to contradict the notion that executives need broad experience across areas of expertise, organizations, and industries, but we see the current marketplace placing a premium on translational leadership skills such as adaptability, collaboration, and communication. Even for specialized roles, employers are looking not for “perfect fits” in their executive hires as much as growth-oriented, results-driven individuals who can thrive when presented with meaningful new challenges.
- Individual success depends on team success. Thriving within a lattice framework places a premium on one’s ability to get along with and team with others for collective success and the good of the whole organization. Across a matrixed organization, building relationships and being a great colleague are critical. As Scarborough puts it, “Your career is a combination of the work that you do and who you become as a member of a team.”
Career Strategies in a Matrixed Environment
For an executive or aspiring leader in a new and continually evolving landscape, a mindset shift becomes critical – an adjustment that aligns with the expanded opportunities and flexibility inherent in today’s healthcare leadership. The lattice requires each executive to weave together a diverse mix of skills, experiences, and personal traits to move purposefully through early-, mid-, and late-career phases. The following are strategies we recommend for getting in the right career mindset:
- Illuminate your own path. Lattice career planning allows for options and levels of creativity that were unseen in the past, which means that you’ve got to work even harder and intentionally on it. Think long term, with the understanding that your journey will have many twists and turns that will be chances to grow. We encourage individuals to look into a range of roles and a broad scope when constructing career plans – even if it means going outside of healthcare for a time. Think about the value of everything you do. Say you’re getting that M.B.A. or M.H.A. degree. What about it is forcing you to grow and develop? How is it making you a better leader?
- Get to know yourself better. A shift toward competencies forces you to understand your strengths and weaknesses well beyond your resume. What do you do well that you can leverage? What are your flaws to work on? Take advantage of behavior-based leadership assessments to provide invaluable self-data. Associate yourself not only with colleagues who make you feel good but those who provide you with honest, candid feedback and advice. One health system CEO we know is a good example of the need to learn about oneself. This individual, a physician, had moved into a Chief Medical Officer role but was not able to land a CEO position that he coveted because he was told he “wasn’t ready.” He took a step back and interviewed physicians and CEOs for advice. He learned he needed more contact with boards to understand governance, a proven ability to manage P&L, and greater managerial skills. He went about finding ways to fill these gaps and, a few years later, landed a CEO role.
- Stick to your true north. On your journey never lose sight of your values. As you navigate the career lattice, stay grounded in, for example, your impact on patient outcomes. This will provide an anchor point even when a path might seem confusing or unwieldy. This might mean putting mission over margins, or keeping a loss leader because it’s right for a care community. Don’t forget to have “boots on the ground” experiences with patients, families, and the community. Stay in touch with what truly matters to you.
- Think competencies in addition to accomplishments. While your resume must still impress, the clients we work with seek leaders who have exceptional credentials and Essential healthcare leadership competencies for today include abilities in change management, talent development, and team development. Even The Well-Managed Healthcare Organization – now in its ninth edition – has been updated to focus as much on the how of leadership rather than the what, emphasizing servant leadership and continuous improvement, team-building, results-orientation, and staff empowerment. Soft skills like authenticity and relatability are critical in a flatter, less command-and-control environment.
- Think experience, not title. Rather than thinking of your advancement in terms of position title, think in terms of experience. What do you see yourself doing not just one, but two jobs ahead of your current position? What competencies would you need to gain in order to advance to that second job? Your next position should prepare you more fully, serving as the stepping stone to a future rewarding role.
- Value loyalty. As we advocate for executives to take on new and different experiences, we don’t recommend “job hopping”. In a situation in which you feel “stuck” or limited in your ability to grow, we suggest: a) giving it time to see if the organization or environment shifts, as often happens today; and then b) working with your employer to redefine your role or look for growth opportunities. Most health systems we work with are thrilled to have executives who constantly want to better themselves and find new ways to make an impact. Explore how you can gain experience and new skills in your current role and organization before looking outside.
- Seek out mentors, allies, and sponsors. Build relationships with leaders who are further ahead of you in your field, or in adjacent areas of expertise which you might one day move into. No matter how much experience you’ve gained during your career, you can always benefit from formal and informal mentoring. Find people who think differently than you do – who can nudge you out of your comfort zone or challenge your assumptions about life and leadership.
Helping Your Executive Peers Thrive in the Lattice
In an environment that values relationships, networks, collaborations, and teams, executives have a greater responsibility to support the professional development of colleagues throughout their professional sphere, not just their direct reports. Be vested in the success of others, helping them to grow and succeed according to their own definitions. What can you as a leader do?
- Serve as a resource. Whatever path you’ve taken, your insight has value to others navigating a lattice-oriented career. Keep an open door. Block off time on your schedule to attend to others’ needs. Listen and provide wise counsel. Seize opportunities to mentor or sponsor.
- Be an enabler. Accept others’ need to grow and light their own paths. Don’t be upset when your reports or team members want a new challenge or even a new job. What might seem like impatience or lack of loyalty to you might really be an urge on someone else’s part to keep growing, developing, and acquiring new competencies. Scout opportunities for others to do something new or even take on an entirely different role in your organization. Serve as a reference should someone you respect want to move to another employer.
- Counsel on competencies. As we mention above, up-and-coming executives must constantly strive to understand their own strengths and weaknesses, especially in terms of leadership competencies. Structure your advice around the following statements: “The things you do really well and should embrace include . . . “; “The things that you can continue to work on include . . . “.
- Be honest. Be kind and diplomatic about it, but tell others what they may not want to hear. Let them know where you see missteps or areas for improvement.
What Health Systems Can Do to Advance Their Leaders
As an executive you have the potential to shape how your organization develops its leaders. We encourage you to help implement the following best practices to support current and aspiring executives in their career growth:
- Support (and fund) growth opportunities. Provide ways for your organization’s best and brightest to learn new skills and expand their horizons. It will help your chance at retaining them for the long term.
- Cross-pollinate. Provide opportunities for individuals to work in areas of your organization that are new to them, and to collaborate with individuals they might not normally interact with.
- Create customized development plans. With each career path unique and different, show your top talent that their individual needs and desires are important. Work with them to map out their futures, often as part of larger succession planning efforts.
- Prioritize potential over past experience. In promotions and hiring, look at what competencies someone has that can serve your organization in one or many roles in the future. You want people with proven success, but recognize the talents that led to their success and how they can be utilized going forward.
- Don’t hold grudges. Understand that driven, growth-oriented professionals may need to leave your organization to advance in their careers or even just scratch an itch to try something different. Show understanding if someone on your team makes a career move that is in their best interest (granted that they do it thoughtfully and respectfully). Embrace them if they someday want to come back to your organization.
Jason Petros is Executive Partner, Executive Search at WittKieffer. Keshia Harris is a Consultant in the firm’s Healthcare Market.
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