Do Health System CEOs Need Chiefs of Staff?

Last night I watched part two of the two-part series “The Presidents’ Gatekeepers,” about presidential chiefs of staffs on The Discovery Channel. The documentary was as entertaining as it was educational, and it got me thinking: Why don’t health system CEOs have chiefs of staff?
Finding a clear-cut definition for a chief of staff was difficult, and Wikipedia offered the best I could find: “the leader of a complex organization, institution, or body of persons and it also may identify a Principal Staff Officer (PSO), who is the coordinator of the supporting staff or a primary aide-de-camp to an important individual, such as a president.”
Harry Truman was the first U.S. president to have a chief of staff, and since then the role has been added to many organizations. Today, many leaders of complex organizations, such as university presidents and state and local government officers, have chiefs of staff to serve as advisors, and largely, gatekeepers.
Many non-goverment top dogs also have a chief of staff. A CNN Money report from 2010 explained that the CEOs at AOL, Goldman Sachs and Aflac, had someone filling this role, and those interviewed in the story expected other companies to institute this type of structure.
The health system CEOs of today manage very complex organizations that may include ten, twenty or more facilities and multiple local markets. Do they need a chief of staff? The question entered my mind while watching the documentary, and while reflecting on how many CEOs I’ve talked to told me they work long hours every day and keep finding themselves with more and more complex tasks and challenges to address.