6 Traits That Define a Great Hospital CFO

What defines greatness? This question is asked frequently in the realm of sports and usually encompasses mass quantities of home runs, touchdowns, goals or 3-pointers.

However, defining greatness in terms of hospital and health system leadership is also asked frequently, though quantitative statistics don't apply. Hospital executives are not usually judged by their ability to run a 4.4-second, 40-yard dash or their propensity to hit big shots in an intramural basketball league.

Narrowed down further: What traits make a great hospital CFO? Accounting and business acumen are almost a given for any CFO — and most CEOs as well. Having the right morals and integrity also are a must for any leadership role. With that in mind, what other traits are at the core of well-rounded, successful hospital and health system CFOs? Here are six that fit the bill.

1. Conviction.
Tom Giella, a managing director of healthcare services at executive recruiting firm Korn/Ferry International who has conducted several CFO searches for non-profit hospitals and health systems, says outside of the CEO, the CFO is the most critical job in a health system. To take the seat of a pertinent position like CFO, a person must have a certain set of values and convictions that line up with both the organization and the community.

Mark Bogen, CFO of South Nassau Communities Hospital in Oceanside, N.Y., agrees. He has more than 35 years of healthcare financial leadership experience, and he says outside of the assumed competencies around finances, CFOs must have some type of conviction and confidence that their decision-making abilities will lead the hospital to great healthcare outcomes, a healthy population and — as a result — a more financially stable organization.

2. Nimbleness and flexibility. Both Mr. Bogen and Mr. Giella caution that while "conviction" is one of the most important traits a hospital CFO can possess, it shouldn't be confused for "stubbornness."

"No one has a crystal ball for healthcare," Mr. Giella says. "And being a CFO is not a one-size-fits-all. CFOs need to be nimble enough, too."

Mr. Bogen recalls a time when he was still in public accounting. A CFO approached him and warned him about hospitals relying on admissions from employed physicians. Twenty years later, when Mr. Bogen became CFO, he ran into the same person and told him about their hospital-physician alignment strategy, which relies heavily now on employed physicians. Mr. Bogen's friend thought it was a fantastic strategy for the time but knew it wasn't back in the day. Mr. Bogen learned that what's good a couple decades — or even a couple years — ago isn't necessarily what's good for the organization now. Conviction sets up a CFO's strategy, but a sense of being nimble allows the CFO to account for the rapidly changing healthcare environment.

"CFOs have to have a strong set of convictions in terms of shaping a strategy, but they can't be so set in stone that it's 'man the torpedoes, full steam ahead' every time," Mr. Bogen says. "You have to reprocess what's going on in the world and sometimes make shifts."

Mark Bogen is CFO of South Nassau Communities Hospital.3. Calm demeanor. Hospital personnel look to the CFO as the person who truly knows if the organization is succeeding or failing. If CFOs create a sense of panic — be it in good times or bad — then it will only create a ripple effect of panic and will bring productivity to a standstill. "This isn't to say you should be keeping important information from people," Mr. Bogen says. "It's about how do you keep your head so others aren't losing theirs?"

Additionally, the CEO and CFO need a solid rapport in meetings and other high-stress situations — even when keeping calm demeanor may not be easy to accomplish.

"If the CEO and CFO aren't on the same page, it never gives me a good feeling of where the organization is when two of the key people are loggerheads on key issues," Mr. Bogen says. "I would never mislead someone, but I really try to approach confrontations in a way that I can get my opinion across but not to the point where we're having open warfare in the middle of a public process."

4. Willingness to understand the clinical aspects. In today's hospital setting, finances are not exclusive of other operations. Mr. Bogen says now, more than ever, finances are intertwined with clinical operations, and a hospital CFO must understand and follow what clinicians are doing on a day-to-day basis.

"I've always said everything that goes on in a hospital affects finances, and finances affect everything in the hospital," Mr. Bogen says. "Quality, patient satisfaction and patient safety are all tied into reimbursement, and a CFO is misinformed if he or she doesn't get involved heavily in those other areas."

Hospital CFOs that pigeonhole themselves into a role of staying away from clinicians, medical talk, blood and on-the-floor procedures are doing a disservice, he adds. CFOs have to at least understand the processes from a layperson's point of view, and the most effective CFOs have great working relationships with physicians, nurses, technicians and others.

"Your primary purpose of being in a hospital organization is to provide care," Mr. Bogen says. "If you don't understand how clinical guidelines and operations are going, you're never going be able to help lead the organization from a financial standpoint."

5. Ability to think long term. Right now, hospital CFOs have a lot of big-ticket, near-term items on their plate: electronic health record implementation, mergers and acquisitions, cost-cutting maneuvers, accountable care organizations, the shift away from fee-for-service Medicare, etc. While those initiatives are crucial to the survival of a hospital or health system, CFOs cannot have tunnel vision. They must be thinking long-term — five, 10, 15 years down the road — to ensure the hospital is well-positioned financially.

"A CEO can have great ideas and visionary places of where he/she wants the organization to be in five to 10 years," Mr. Giella says. "But you need the finance person to really be the conscience of the organization — is this doable? Do we have the financial strength to fund these initiatives? A good CFO is going to be very sharp in strategic capital planning, and if you don't have strong financial strategic planning, it's vaporware."

6. Sense of humor. Hospital CFOs are usually (and unfairly) stereotyped as people who work behind the scenes, speak only in charts and enjoy abacuses and calculators. However, successful CFOs are more than what the stereotypes suggest, and a sense of humor is a foundational trait.

Having a sense of humor is a trait that transcends the hospital CFO position. It's important to have in any job. However, Mr. Bogen says because the healthcare CFO is enduring more and more pressure to keep the organization solvent, a sense of humor is needed now more than ever. "In 2008, when everyone was tightening their belts, my secretary found a website, and she printed out a booklet that had the word 'no' written out in 500 languages," Mr. Bogen says. "I would put that booklet down when someone asked me for something, but of course I referred to it in a kidding fashion."

He adds that CFOs need to understand when the path to say "no" is the right path, but at the same time, they still must be approachable for all members of the organization. A sense of humor invites a more open dialogue and puts people more at ease for when they need to talk about serious issues.

More Articles on Hospital CFO Leadership:

117 Hospital CFO Profiles

7 Projects Hospital CFOs Should Focus on in the Final Months of 2012

What Does it Take to Be a Hospital CFO Today? 6 Thoughts From Lowell General Hospital CFO Susan Green

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