Lonely at the Top: Why CIOs Rarely Become CEOs

Currently, the CIO career path rarely leads to the corner office.

Of 384 hospital executive personnel changes in 2014 analyzed in a recent Billian's HealthDATA study, just one involved a CIO promoted into a CEO role (Matt Gorman, promoted from CIO to administrator of Polk Medical Center in Cedartown, Ga., in June).

These findings don't surprise Laura Musfeldt, vice president of senior executive search at healthcare-focused executive recruitment firm B. E. Smith. "We're just not seeing it," she says. "Other people are making that jump, CFOs or CNOs are becoming CEOs, but not really CIOs."

She suggests one of the reasons CIOs aren't often promoted to CEOs is they have historically been technology executives first, healthcare executives second. "Providers are looking for CEO candidates with experience across all categories," she says. "CIOs traditionally have started with a strong background in technology and have learned the clinical side later. But right now, there's such an abundance of candidates who know the clinical side of the business, it puts CIOs at a disadvantage."

The need for a healthcare background to make it to the CEO role was not lost on Yousuf Ahmad, DrPH. Dr. Ahmad, who started his career as a software developer, soon moved into healthcare, holding CIO roles at Group Health Associates and Mercy Health, both in Cincinnati. But with his eye on the corner office, Dr. Ahmad returned to school to get an education that would help him make the CIO-to-CEO leap. "I don't know another CIO who has a doctorate in public health," he says. "But I wanted to understand population health at its core, so when the time came I could talk about and implement accountable care organizations and other issues [facing healthcare]."

It paid off — in June 2013, Dr. Ahmad was promoted to market president and CEO of Mercy Health – Cincinnati after leading and growing the system's medical group and overseeing several service lines, including heart care.

He says his CIO background has proved useful in his new role. Before embarking on new projects or selecting vendors as a CIO, he spoke with stakeholders and considered data from a variety of sources to come to the best decision — the same process he goes through as CEO. "[In both roles] you get all this data from disparate sources and have to make it into intelligent information that can help you make a decision," he says.

Being a CIO has also taught him how much everyone in the hospital relies on the executive staff to keep things running. "A lot falls on the CIO's shoulders," he says. "They're running all these things that can't fail — payroll, billing, clinical systems. All of these systems have to stay online, people's lives literally depend on it." CEOs face the same kind of pressures to keep everything running, says Dr. Ahmad, just on a larger scale.

CEOs also face these pressures alone. As a CIO, Dr. Ahmad could consult with and ultimately defer to the CEO on difficult decisions. Now, he's on his own, he says, which has been one of the biggest challenges in moving from the CIO to CEO role. "You have to make the decisions and you have to live with them, by yourself," he says. "I would definitely say it's lonely at the top."

Dr. Ahmad also isn't surprised more CIOs aren't becoming CEOs. It's not due to lack of talent among his CIO colleagues, he says, but a lack of interest in running a hospital. "I married healthcare 20 years ago, I knew this was what I wanted," says Dr. Ahmad. However, he says other CIOs may not want to invest like he did in learning all the ins-and-outs of healthcare as many may not want to stay in healthcare forever. "I think a lot of technology executives want to stay industry-agnostic," he says, giving them the flexibility to move into another industry.

Russ Branzell, president and CEO of the College of Healthcare Information Management Executives, says CIOs aren't coveting the hospital's corner office because they enjoy their current role, especially as the role of CIO grows in importance.

"It's not a lack of skill, they understand how to effect change and they could easily move [into the CEO role]," he says, citing George Welton, CEO of Select Specialty Hospitals in Denver and himself, the former CEO of Colorado Health Medical Group in Loveland, Colo., as former IT executives who transitioned into the CEO role. CIOs know how to work with different departments, they know how to manage a staff and they know how to build support for new projects or systems, he says.

As CIOs take on more and more responsibility within hospitals and health systems, there will be more opportunities for CIOs to "spread their wings," says Mr. Branzell, and he predicts this may lead to more CIOs moving into a CEO role.

But just because the path may be easier doesn't mean CIOs are anxious to take it. "They're just looking at what CEOs have to do, and they don't often desire it," says Mr. Branzell. "As crazy and high-stress as it is, they like the lifestyle of a CIO."

More articles on CIOs:

Johns Hopkins' Stephanie Reel: What makes a great CIO
The life of a healthcare CIO: Truman Medical Center's Mitzi Cardenas
CIOs: 3 steps to a strategic vision


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