Executive MBA for Physicians Blog

Educating physician leaders in the new science of medicine and management

Tag: CMO

EMBA Alum Discusses His Role as CMO in an HCA Hospital

Below is an interview with Dr. Bill Killinger, CMO of a major hospital in Florida and Class of 2020 Executive MBA graduate.

Please tell us about your role. What are you responsible for?

I am the Chief Medical Officer for a large HCA hospital in Florida. It’s a great job. As CMO, I have numerous responsibilities. I am first and foremost in charge of patient safety and the quality of care delivered in my hospital. HCA makes patient safety a priority; we use over 30 dashboards to track process improvement and ensure quality. I am also accountable for driving satisfaction in three arenas: with patients, physicians, and employees.  Ensuring high levels of satisfaction in all three areas is critical to achieving our mission. The CMO has significant operational oversight for the emergency rooms and procedural areas and with overall hospital operational efficiency in terms of length of stay. As part of the executive team, I am heavily involved in financial planning and growth, and I work directly with the CEO and COO on new program development, marketing, and strategic planning. Finally, as the senior clinician, I help explain clinical matters to the Board of Trustees. I wear a lot of hats. Every day is a different challenge!

How has your work changed as a result of COVID-19?

I had been in my role as CMO for 4 months when COVID hit. I was just really learning the operations and getting to know the medical staff. Almost overnight, the world changed. We were very cognizant of the situations in Italy and in New York City. We were not sure how hard we would be hit here in our area. I was communicating with county emergency leaders almost daily and reached out to the CMOs at our competing hospital to form county-wide contingency plans. My hospital held emergency administrative meetings 7 days a week, sometimes multiple times during a day as we managed PPE, ventilator, and ICU bed shortages and scrambled to fill staffing shortfalls. It was wild. I had to organize hospital triage committees and action plans to prepare for the unthinkable prospect of an overwhelming influx of critically ill patients. We spent a lot of time with the ethics committee to ensure our triage plan was equitable in the event we were faced with a situation like in Bergamo, Italy.

We also operate a freestanding Behavioral Health hospital, which presents several unique challenges. We had to develop an entirely different strategy to keep that vulnerable population safe. Early on, we implemented universal admission testing and employee masking- well before it was recommended. Our strategy has been effective. We have had no patient deaths or serious illnesses in that hospital so far.

What have been the differences between your experience at a nonprofit and a for-profit healthcare organization?

I was initially concerned about the transition from the not-for-profit world to the corporate world. I can honestly say it has been great. We have four care standards which are central to everything we do. In order, they are safety, hospitality, empathy, and efficiency.  We take these very seriously and consider every decision first in terms of the care standards. They are the core of who we are and what we do. Patient safety is always first. Notice that efficiency is last; it’s very important but never trumps the other three standards. I actually have more safety resources here than I had in my previous institution.

How has the EMBA for Physicians program (and any specific skills and tools you learned) helped you in your CMO role? In your response to COVID-19?

The EMBA has been helpful in so many ways. The strong focus on organizational leadership was crucial. Leadership is a skill, and I learned a tremendous amount from the faculty. I had zero background in finance, and the accounting and corporate finance courses have proven to be invaluable. This I think is the key advantage of the MBA over an MHA; I understand and can actively participate in the budgeting and strategic planning for my hospital in a way I could have never done without the Brandeis program. The courses were tough but are paying big dividends (corporate finance pun!). There were so many other important courses – healthcare law and ethics, marketing, state health policy – I use the learnings from the EMBA every day.  Putting together the team consulting project gave me confidence I could navigate a complex project through to completion. The physician field experience sessions, especially the media relations seminars, were especially valuable to me. I’ve found myself unexpectedly in front of the camera or microphone several times in the last six months, and that training was worth its weight in gold.

My classmates were some of the most impressive people I’ve met. I have reached out to them on many occasions since graduation for advice. It’s a tremendous honor to be a member of this network. I would recommend this EMBA program to anyone. You will work really hard, but the faculty is great, your classmates are great, and if you put in the effort, you can do it. It’s among the best decisions I’ve made.

It’s nothing like it was: EMBA for Physicians Alumnus Dr. Tom Tracy on his experience after the program

Years ago, my wife and I tasted the most incredible pinot noir. Long after, we visited the winery where it was made. The owner took us to every corner of the vineyard to help us understand the hard work that went into the experience of every sip. Every small detail– why those particular cultivars, the specific days of harvest, the microclimate on that hill, and the barrels in this shed– helped us to better understand and value the wine. This wine for us is now nothing like it was before we had this experience.

As my career progressed through the surgical care of children, to the development (and funding) of a respected lab, and to the opportunity to lead and grow a new children’s hospital, I found the challenges tremendously satisfying. As “the crucibles of leadership” presented themselves, I found I could get through them more or less by following prior examples, good or bad. The teams I had were adequate and collegial but often hindered by limited know-how. I was at the table for most conversations mainly out of respect, not expertise or enlightened perspective. Like many in academic medicine, I had arrived at the role of Chief Medical Officer with enthusiasm for the opportunity to help make clinicians, their teams, and their programs successful. But is enthusiasm enough? How would my partner executives and I actually help the organization harness and deliver the innovations just over the horizon? I knew enough to know that, as in medicine, a deep fund of knowledge and the understanding of how to apply it was critical to successful healthcare leadership.

I had considered business school many times for no specific reasons. Finance or project management, marketing and economics, even strategy, were the scattered and poorly understood concepts that I contemplated. Ultimately, I just couldn’t see the return on investment.  That is, until I reached a point where I was floundering to conceptualize, develop, and deliver meaningful solutions. I could no longer fall back on, or move forward with, solely my past experiences.

Brandeis’s Executive MBA for Physicians was a chance and a risk for me and my growth as a leader. Together with a group of unique and very accomplished classmates, we were led through each business foundation to discover just how much we lacked in our background and experiences. The program, like the tour from the wine makers, gave us the opportunity to break down the elements of a process, understand them more fully, and explore how to best fit them together for your desired results.  We eventually developed into master blenders who could craft future paths through intersections of business, policy and clinical care.

Currently, I am a CMO in a big system with a large scope. My perspective now reaches further than managing a greater number of direct reports, interacting with cost centers, or ensuring a place at the table with accomplished leaders. The EMBA developed in me different and powerful faculties and internal resources. As a result, I can use my better understanding of complexities, required collaboration, and meaningful controls to find new ways forward. The barriers to health care delivery, in reality, have not changed, but my former frustration rapidly fades into fair process and business systems approaches to bring the best into and out of any challenge.

I had a call with my long time executive coach one afternoon after a particularly intense series of crises. I shared with him just how much the change I had experienced during the EMBA meant to me. I now brought a different skill set to working with an associate to bring a new genomic test “into our market” or with lean teams to develop new operational excellence at an over-capacity surgical service. Three more examples later my coach cut me off and said, “For now I’m going to leave you in your bliss, we’ll talk next month” and hung up. Listening to the dead receiver I thought, “Just like the wine, now it’s nothing like it was.”

Dr. Thomas Tracy is an EMBA for Physicians alumnus, class of 2017 and is currently the CMO in a large medical system.

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