Commit to going 'all in': Advice from a CFO-turned-CEO

When a CFO decides they want to become a CEO, they must commit to that path, said David Cauble, CEO of Klamath Falls, Ore.-based Sky Lakes Medical Center.

It was a piece of advice he took to heart. Mr. Cauble made the jump more than a year and a half ago, taking the helm at the rural Oregon hospital after serving as CFO of Children's Mercy Hospital in Kansas City, Mo. 

"When you're in the interview process, you can't be saying, 'Well, if I don't get this, I'll go find another CFO job,'" he said. "It just reflects [that] you're not really committed to it."

Mr. Cauble said that can be scary for some, "but you come across as a much stronger candidate if you're fully invested, you're all in saying 'this is the path I'm on. I intend to be a CEO.'" 

His own ambition to become a CEO evolved over his career. 

"As a chief financial officer, you have a lot of influence," Mr. Cauble said. "You can make a lot of strategic decisions and you're involved in a lot of those conversations. But at the end of the day, you're still executing on someone else's strategy, someone else's vision and, hopefully, you've got a good leadership team where you're still finding value in that. 

"But for me, I was to the point where I thought that I really wanted to try to make an impact and perhaps do some things differently than what I've seen done elsewhere. And then the way for me to be able to effect that kind of change and have that kind of team was to do it through the role of a CEO. And even more specifically than a CEO, I was interested in rural healthcare." 

For CFOs looking to move to a CEO role, it is important to move outside the finance domain as much as possible, he said. 

"In one of my earlier roles in a rural community, I actually had operational responsibilities for some things that are maybe unusual for a CFO, but it gave me operational experience, which was important to understand," he said. "Building relationships with physicians and medical staff is essential, and oftentimes the CFO is not a part of those conversations. ... You have to learn how to engage with physicians and other providers, and you're not necessarily going to do that if you're just known as the chief accountant." 

A helpful piece of advice Mr. Cauble received about stepping into a CEO role was to be patient and resist the urge to come in and start making changes. 

"Sometimes people want to come in and just make a big splash," he said. "That's not the path forward. And that's true whether you're a CFO coming into the CEO role or a new CEO, period."

It is important to listen and learn the culture, he said. At Sky Lakes, he was succeeding a CEO who had been at the helm for 30 years and had been very successful. 

"And so if you come in and start making a lot of changes, then you do get some natural resistance because what they were doing was working," he said. "So it almost looks like you're making changes for the sake of change and not really doing it with a meaningful purpose. Giving yourself time is critical to figure that out. And then you build the, so to speak, political capital, you build those relationships, where then when you're ready to make a change, you have some dialogue and conversation about it and people understand why you're wanting to do something."

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