A 'burning platform' is changing the chief medical officer role

Financial stress, labor issues and employee burnout are challenging chief medical officers at hospitals and health systems. Bill Bornstein, MD, PhD, told Becker's these crises can lead to revolutionary change. 

In the last two to three decades, chief medical officer roles have evolved from solely focusing on clinical services, such as managing length of stay, to working on operational and financial matters. Their role might see another big shift in the next few years, CMOs told Becker's, as hospitals face a cascade of disruptions. 

Dr. Bornstein, the CMO and chief quality and patient safety officer at Atlanta-based Emory Healthcare, said many health systems are in crisis mode as the cost of providing care surges.

CMOs have wanted to make powerful changes to the healthcare delivery model for years, he said, but there was little incentive to make radical decisions when business was doing well. 

Now, hospital budgets are in trouble. 

"This is the most significant financial challenge we've experienced in all the time I've been in this role," Dr. Bornstein said. "It's a little bit scary, but it's also potentially exciting from the standpoint of sometimes it takes crises to create important innovation and change. … While these financial pressures are unprecedented, the opportunities and tools we have are also unprecedented."

Marc Napp, MD, who filled various vice president of medical affairs and CMO roles for about 20 years before becoming CEO of the Trajectories Company, said other pressing issues include workforce burnout, the changing physician employment model and higher expectations for CMOs. 

His most previous CMO jobs include New Hyde Park, N.Y.-based Northwell Health, Mount Sinai Health System in New York City and Memorial Healthcare System in Hollywood, Fla. He said he chose to leave hospital leadership after seeing little improvement to the industry's dysfunctions. 

During the first two to three months of the COVID-19 pandemic, he said, "I saw collaboration, teamwork and a single purpose of mind like I had never seen healthcare before." All were unified toward one mission: to save as many lives as possible when little was known about the novel coronavirus, Dr. Napp said. By mid-2020, though, political and fiscal issues grew as fatigue set in and labor costs rose. 

Experts said the healthcare industry has now reverted to its pre-pandemic problems, which will continue festering unless bold action is taken. 

Dramatic change has begun entering healthcare C-suites, such as the renewed focus on employing physician and clinician leaders. For example, Johnson City, Tenn.-based Ballad Health altered its chief medical officer structure in August to sponsor more physician leaders. 

"We've got physician leadership infused throughout the entire organization," Alan Levine, chair and CEO of Ballad Health, said. "At this point, I wouldn't do it any other way."

As innovations weave through hospital C-suites, CMOs are being weighed down with crushing responsibilities surrounding equity, quality, budget control and labor problems. 

The swirling headwinds could be for the better, Dr. Bornstein said: "Sometimes, it takes a bit of a burning platform to really create important, meaningful and exciting change."

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