Few health systems have developed as many executive leaders as Cleveland Clinic. The answer to why, according to one of its most senior physician-executives, is less about culture than about a set of specific institutional practices that begin early in the process.
Tommaso Falcone, MD, executive vice president and president of international and emerging markets at Cleveland-based Cleveland Clinic, spent 17 years as chair of the department of obstetrics and gynecology before taking on progressively larger leadership roles — chief of staff at Cleveland Clinic London, president of the hospital, and now EVP of international operations. The arc is not unusual at Cleveland Clinic. It is the model.
“Every since I remember, we meet with our CEO, and we discuss — and it’s not just me as a clinician leader or just an executive leader, everyone does this,” Dr. Falcone said. “And they ask us: Do you see people that have expressed a desire to be a leader?”
The question covers leaders who have raised their hand and those who haven’t but whose behavior suggests they would be an excellent fit. When someone joins Cleveland Clinic, the organization starts assessing performance and future growth trajectory, and it distinguishes between two distinct types of emerging leaders.
“Leadership is part of the type of professional development that we aspire to, that we encourage,” he said.
For both types of leaders, self-identified and executive-identified, the conversation starts quickly.
“For those that have a natural leadership, we ask them: are you interested in this, or is it that you feel perfectly happy doing what you’re doing? And this occurs almost immediately as soon as you become part of the Cleveland Clinic as a caregiver at any level,” he said.
Dr. Falcone’s own path illustrates the philosophy. The transition from clinical leadership to executive leadership is not treated as a single decision but as a continuum.
“The transition was always an evolution,” he said. “It was not that today I’m a gynecologist and tomorrow I’m in a high-level leadership role. It evolved.”
The model has a built-in release mechanism. Leadership roles at Cleveland Clinic cycle — clinical chairs move into other roles to create space for the generation behind them. Dr. Falcone pointed to Frank Papay, MD, who led the plastic surgery department for many years before transitioning into business development within Cleveland Clinic’s innovation function.
“Once you’ve done a clinical leadership role, you have to give opportunity to another generation,” Dr. Falcone said.
Underlying all of it is the instinct to think beyond one’s current contribution. Cleveland Clinic treats that instinct — expressed as a small idea, a proposed improvement, a question about how something could work differently — as the earliest indicator of leadership potential. Then the capacity for innovation is a prerequisite for any kind of leadership role.
“I don’t think you can be a leader without being innovative,” Dr. Falcone said. “Innovation — and I don’t mean I just developed a new procedure to do surgery. It could be an innovation in delivery of healthcare. It could be innovation in the way we interact with the global community.”
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