Career Inflection Points Differ by Functional Background

This is the third in a series of posts providing insights from a recent study conducted by NCHL with investigators from the University of Michigan. The study analyzed the career trajectories of women who successfully achieved the hospital CEO position to determine the factors that generated inflections in their careers.

This blog highlights the differences in career inflection points for women who began their careers in healthcare management.

In our study of 20 successful women hospital CEOs, we identified different inflection points for those who began their career in healthcare management versus those who began their career in a clinical or administrative support area (for example, accounting). We describe some of the differences here and also note how these differences appear to converge at the COO position.

With a few exceptions, most of the women we interviewed described how their work experiences fell within their primary functional area until they entered the senior-executive ranks. For example, most of the healthcare management executives started as associate administrators or the equivalent and one started as a healthcare consultant. All of them had follow-on administration positions within the core business areas of a hospital. As they ascended in the leadership hierarchy, most reached the director or vice president of operations position on a trajectory that ultimately led to COO and then CEO.

As for education, those starting in healthcare management graduated with a master’s degree in healthcare administration or public health and then immediately completed an administrative residency or fellowship. During this training, they were closely mentored and sponsored by senior executives and their experiences gave them a broad understanding of hospital operations. These early career inflections were described as creating major differences for them throughout their careers.

On the other hand, the CEOs who began in clinical or administrative support positions followed different career trajectories. All started as professional staff members and moved into management positions within their functional area later in their career (e.g., nursing, accounting). Several mentioned taking risks by moving into positions outside of their primary functional area in order to expand their knowledge and experience of operations. A number of them also indicated how mentors and sponsors helped them move into these types of career developing positions.

For the most part, the mentors and sponsors were within the executive’s primary functional area.  For example, nurses were most often mentored by senior nurses or the CNO. These executives appeared to be ascending towards the senior-executive position within their functional area.

In terms of education, this group of executives obtained graduate education later in their career in order to advance in management. They revealed that sponsors directly supported their effort to going back to school and some said the hospital provided scholarships for them. A few mentioned they received on-the-job training and mentorship from the COO or CEO in lieu of completing an administrative residency or fellowship.

An interesting finding was that almost all of the women had been COOs before being CEOs, even those who had previously been CNOs. Although the trajectories started to converge at the COO position, there was still a difference in terms of mentoring and sponsoring relationships. For instance, nearly all of the executives mentioned the hospital CEO mentored and sponsored them when they became the COO. The clinical and administrative support executives, however, mentioned they were mentored or sponsored by the COO or other senior executives until they were ready to move to the COO or CEO role. Thus, it was harder for them to move into COO or CEO positions. Some mentioned how this type of bias influenced them to move to another organization in order to become a CEO.

What do these various paths/inflection points mean for current and future clinicians who want to lead an organization? What skills do clinical and support service leaders need to ascend to the C-suite?

About Christy Lemak

teacher and scholar interested in strenghthening leadership in health care

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Blog of the National Center for Healthcare Leadership

Fieldnotes on Leadership in Health and Healthcare

Fieldnotes on Leadership in Health and Healthcare

Health Affairs BlogHealth Affairs Blog

Fieldnotes on Leadership in Health and Healthcare

%d bloggers like this: