Healthcare 'free agents': Hospitals embrace on-demand leadership

Tackling today's healthcare challenges requires that organizations make adjustments based on project and business needs. In doing so, some hospitals and health systems are bringing in on-demand leadership to provide expertise.

Areas in which organizations seek expertise include financial controls, accounting and audit; organizational design and workforce planning; and technology and systems implementation. 

"They are free agents. They're independent and available to jump in and out of the organizations they serve, either by providing a proper coverage to a gap, like being an interim leader sitting in a gap, or to the augmentation of injecting skills and experience around a particular topic or movement in the business cycle," said Sandra Pinnavaia, global head of strategy and innovation for on-demand talent at Heidrick & Struggles, a Chicago-based global executive search and consulting firm. Ms. Pinnavaia also leads the product innovation team at Business Talent Group, a Heidrick & Struggles company.

She and Feby Abraham, PhD, executive vice president and chief strategy officer for Houston-based Memorial Hermann Health System, recently spoke with Becker's about the role of on-demand executives, how they are used and the challenges and benefits of using them.

What is an on-demand executive? 

An on-demand executive is an independent and established business professional — ranging from the C-suite to the director level, or a management consultant — who provides executive-level support to organizations. They are typically not looking for permanent positions but rather are brought in on a temporary basis for reasons such as leading a particular project, filling interim roles during transitions, providing strategic expertise or addressing specific challenges.

Globally, Business Talent Group has a network of about 30,000 independent business professionals available for deployment to organizations as needed. Healthcare is among BTG's fastest-growing segments and its eighth most-served industry sector in the U.S. In total, more than 8,600 people in BTG's network list healthcare as one of their top two areas of focus. This includes executives who are not retired and have, on average, 15 to 20 years of healthcare experience.

Ms. Pinnavaia attributes this growth to an evolving industry.

"The business challenges in healthcare are getting bigger every year," she said. "They're very high stakes, because people's lives are at stake. 

"Our clients are trying to do major digital transformations and technology evolution. They're all doing very interesting strategic partnerships. There's a lot of consolidation in the industry. And there's just tons of enterprise transformation. So the leaders in healthcare are particularly stretched. And they can't hire permanently for everything, and they have to maintain a nimbleness or agility as they navigate through all the things that are happening."

How are on-demand executives used? 

On-demand executives are used for a variety of projects. Some examples include serving as an interim CIO to support IT systems infrastructure and cybersecurity compliance strategy; developing an organization's talent acquisition capabilities; or serving as an interim controller to lead the accounting function during the search for a permanent hire. Such an executive also could be asked to run a partnership between the health system and another provider, company or institution.

Memorial Hermann used an on-demand executive to help streamline and remove duplication of common activities conducted between a business partner and the health system. 

"Hiring an adviser or consultant team to drive a lot of the work would not be as effective, because what was required of the work was less analytical and more influencing and understanding and influencing leaders across the organization, on a specific topic," Dr. Abraham said.

The benefits and challenges

That full-time leader worked on the Memorial Hermann project for about five months in 2023. The individual spent time listening to people doing the same set of activities with the health system, those doing the same activities with its partner, and those involved in the interface between the two organizations. 

"What we needed was a leader to come play a temporary role to scope out and do a mapping of the areas of opportunity, and eventually create the workflow that can lead to [the desired] end state," Dr. Abraham said. 

This is exactly what resulted, according to Dr. Abraham. However, he acknowledged there were speed bumps.

"Many of the challenges revolved around crafting the role description up front, finding the right candidate, and then getting feedback to maximize the impact of that on-demand role itself," Dr. Abraham said. "How do you shape the role over time, looking into the future? What adjustments might you make to personnel to achieve that? These were all questions and challenges we had to overcome."

Still, he said he views on-demand leaders as people who can "create momentum [on a project] without a long-term engagement with our system" when there is no definitive construct of what an organization wants a function or role to look like. 

He also said these roles provide opportunities for leaders with extensive healthcare experience, allows for a faster track to build momentum, and allows for developing a clearer vision for the long-term, full-time version of roles. 

Ms. Pinnavaia echoed Dr. Abraham's sentiments, speaking to both the advantages and challenges of on-demand leaders.

"We know it's effective because we see [clients] come back to us," she said. "We talk to the clients while their projects are going on. And they are relieved and grateful and happy to be having this kind of expertise come in." 

"This is a growing category. But yes, it's not magic. In other words, to effectively use and efficiently use on-demand talent, it takes an intermediary that advises both sides of the equation about how to make the project successful, how to structure the project, how to onboard someone, how to really make sure it's going well. Secondly, it takes talent that has really done this before. This is why you see, when we're onboarding people into our network, we want people who are really established as independent, and they are skilled in jumping into these situations. They're not just someone who's in between jobs. So, it is a learning muscle."

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