Plastic Surgeons as Institutional Leaders.

BACKGROUND: Physicians, especially plastic surgeons, are underrepresented in hospital leadership. As such, the steps an aspiring plastic surgeon should take toward assuming a high-level administrative role remain unclear. The authors aim to profile the chief executive officers and surgeons-in-chief at top-ranked U.S. hospitals with the goal of better characterizing the attributes of institutional leaders. METHODS: Chief executive officers and surgeons-in-chief at top-ranking hospitals in the 2019 to 2020 U.S. News and World Report "Best Hospitals Honor Roll" were included in this study. For each leader, sex, title, degrees, years of experience, total number of publications, practice specialty (for physician leaders), and previous leadership roles in national societies were reviewed. Descriptive statistical analyses were performed. RESULTS: A total of 99 leadership positions at 66 institutions were included. Of these, 67 were chief executive officers and 32 were surgeons-in-chief. Overall, 28 of 67 chief executive officers (42 percent) were physicians-23 nonsurgeons and five surgeons. Of all surgeon executives, only two were plastic surgeons, and both were surgeons-in-chief. The "average" physician-chief executive officer had 24 years of experience, no M.B.A., over 100 publications, zero to one fellowship, and was involved in national leadership. There was no difference in professional qualifications (defined as years of experience, business training, number of publications and fellowships, and leadership positions) between nonsurgeon- and surgeon-chief executive officers, or between plastic surgeons and other surgeons in leadership positions. CONCLUSIONS: Despite possessing adequate qualifications, plastic surgeons are underrepresented in American health care institutional leadership roles. Aspiring plastic surgeon leaders should lean on their peer credibility and experience delivering patient-centered care to succeed in leadership roles.

Changes in hospital CEO profiles in Poland-Professionalisation of management?

PURPOSE: To present and discuss the findings of surveys on the profiles of hospital CEOs in Poland, as carried out in 2012 and 2017, involving over a hundred hospital CEOs at various reference levels. FINDINGS: The findings indicate appreciable changes in the group under study. While until recently, a typical hospital CEO was a male physician; presently, there is a fair proportion of women (36%). The majority of CEOs are non-physicians (63%), whereas previously, they accounted for approximately 63% of them. Mean work experience in public health care for male CEOs tends to decrease, whereas an opposite trend is well manifested with regard to female CEOs. It was also established that hospital CEOs were steadily less keen on improving their professional qualifications through postgraduate courses. CONCLUSION: These changes may imply a kind of "stabilisation" within the sector itself or a departure from the all-male, medicine-centred model of hospital management. They may have been caused by climbing expectations regarding overall management expertise and a higher salary level offered to physicians. Changes in individual work experience seem to indicate that men are more often "transplanted" from other industry sectors, whereas women tend to pursue their entire career path in public health care institutions.

Gender Differences in Hospital CEO Compensation: A National Investigation of Not-for-Profit Hospitals.

Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent to fulfill an organization's goals and mission. This study used national, large-sample data to examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual compensation for female CEOs in 2009 was $425,085 compared with $581,121 for male CEOs. With few exceptions, the difference existed across all types of not-for-profit hospitals. After controlling for hospital- and area-level characteristics, female CEOs of not-for-profit hospitals earned 22.6% less than male CEOs of not-for-profit hospitals. This translates into an earnings differential of $132,652 associated with gender. Explanations and implications of the results are discussed.

The Relationship of Hospital CEO Characteristics to Patient Experience Scores.

EXECUTIVE SUMMARY: Efforts by hospitals to improve patient experience continue as changes in policy such as the Affordable Care Act of 2010 have made patient experience a cornerstone of promoting greater value in the United States. Hospital CEOs play an important role in promoting positive patient experiences as they set the organizational vision and strategic goals and can execute change to support positive experiences.This study assessed whether three CEO characteristics-education, tenure with the organization, and gender-were associated with patient experience scores of California hospitals in 2013 and 2014. Using a pooled, cross-sectional design with ordinary least squares regression to account for other hospital and market characteristics, the analysis indicated that hospitals with female CEOs and longer-tenured CEOs were associated with more positive patient experience scores. Higher levels of education were not significantly associated with patient experience scores. Overall, the model covariates accounted for approximately 14.0% of the variance in patient experience scores between hospitals, with CEO characteristics accounting for approximately 2.4% of this variation. Such findings highlight the important yet emerging role of CEO characteristics when accounting for patient experience.

Hospital Chief Executive Officer Perspectives on Health Care Administration Academic Preparations.

A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. A post hoc review of 3 secondary data sets (previous parallel surveys administered in 2007, 2011, and 2015) was conducted to determine what preferred academic program of study (master of health administration, master of business administration, or a clinical degree preparation) may exist by current hospital executives and potential trending of executive degree preparations over time. In addition, any relationships among individual hospital administrator, individual personal characteristics, and their preferred degree preparations were also investigated at an exploratory level. Findings suggest and support the researchers' hypothesis that the preferred degree preference for a career in hospital administration (master of business administration, master of health administration, or clinical) is highly dependent on an individual executive's graduate degree earned. Many areas for future research are identified from this study that include additional survey analysis and future research questions related to initial findings.

Prevalence and compensation of academic leaders, professors, and trustees on publicly traded US healthcare company boards of directors: cross sectional study.

OBJECTIVE: To identify the prevalence, characteristics, and compensation of members of the boards of directors of healthcare industry companies who hold academic appointments as leaders, professors, or trustees. DESIGN: Cross sectional study. SETTING: US healthcare companies publicly traded on the NASDAQ or New York Stock Exchange in 2013. PARTICIPANTS: 3434 directors of pharmaceutical, biotechnology, medical equipment and supply, and healthcare provider companies. MAIN OUTCOME MEASURES: Prevalence, annual compensation, and beneficial stock ownership of directors with affiliations as leaders, professors, or trustees of academic medical and research institutions. RESULTS: 446 healthcare companies met the study search criteria, of which 442 (99%) had publicly accessible disclosures on boards of directors. 180 companies (41%) had one or more academically affiliated directors. Directors were affiliated with 85 geographically diverse non-profit academic institutions, including 19 of the top 20 National Institute of Health funded medical schools and all of the 17 US News honor roll hospitals. Overall, these 279 academically affiliated directors included 73 leaders, 121 professors, and 85 trustees. Leaders included 17 chief executive officers and 11 vice presidents or executive officers of health systems and hospitals; 15 university presidents, provosts, and chancellors; and eight medical school deans or presidents. The total annual compensation to academically affiliated directors for their services to companies was $54,995,786 (£35,836,000; €49,185,900) (median individual compensation $193,000) and directors beneficially owned 59,831,477 shares of company stock (median 50,699 shares). CONCLUSIONS: A substantial number and diversity of academic leaders, professors, and trustees hold directorships at US healthcare companies, with compensation often approaching or surpassing common academic clinical salaries. Dual obligations to for profit company shareholders and non-profit clinical and educational institutions pose considerable personal, financial, and institutional conflicts of interest beyond that of simple consulting relationships. These conflicts have not been fully addressed by professional societies or academic institutions and deserve additional review, regulation, and, in some cases, prohibition when conflicts cannot be reconciled.

Career histories and managerial performance of health care chief executive officers: an empirical study in the Italian National Health Service.

BACKGROUND: Organizational studies widely acknowledge the importance of the relationship between CEO's career histories and managerial performance. Although the health care management literature largely explores the role of CEOs, whether and how top managers' career histories affect their own performance remains still unknown in this industry. PURPOSE: The aim of this study was to investigate the career histories of health care CEOs and to explore their impact on managerial performance. METHODOLOGY: Primary data were collected from a sample of 124 CEOs leading health care organizations in the Italian National Health Service in 2008. Biographic data were accessed to gather information about relevant CEOs' demographics and their career histories. The relevance of CEOs' prior experience was considered, taking into account the prominence of health care organizations in which they passed through in their career histories. Regression analyses were employed to assess the impact of CEOs' career histories on their managerial performance. FINDINGS: Top managers already appointed as CEOs were more likely to achieve higher levels of performance. Careers with long tenure within the National Health Service appear to increase managerial performance. Those CEOs who accumulated prior experience in a large number of health care structures and who spent time working at the most prominent hospitals were also more likely to achieve higher levels of managerial performance. IMPLICATIONS: In health care, a CEO's career history does impact his or her managerial performance. Specifically, patterns of career that imply higher mobility across health care organizations are important. Although interorganizational mobility is significant for CEO performance, the same does not hold for mobility across industries. These findings contribute to the current debate about the need for management renovation within health care organizations.

Rural mental health workforce needs assessment - a national survey.

INTRODUCTION: A variety of studies have indicated that rural communities have fewer mental health services and professionals than their urban counterparts. This study will examine the shortages of mental health professionals in rural communities as well as the impact of inadequate mental health services access on rural hospitals. METHODS: A sample frame of 1162 rural hospitals was compiled, and a two-page survey was mailed to each hospital Chief Executive Officer (CEO). RESULTS: Of the 1162 surveys mailed, 228 were returned. The majority of CEOs agreed that there was a shortage of mental health professionals, that referral centers were too distant, and that there were many barriers to care including infrastructure, poverty, and substance abuse. Solutions offered by CEOs included telemedicine and residency training programs. CONCLUSIONS: This study shows that many rural areas have great need for more mental health professional recruitment and retention.

Factors affecting the value of professional association affiliation.

BACKGROUND: The resource-based view of the firm suggests that organizations must obtain valuable resources from external sources to obtain lasting benefits. Professional associations today exist in every industry and offer resources to assist their affiliates' organizations and individual members. Today, there are more than 23,000 national and 64,000 state, local, and regional professional associations that claim to significantly benefit their affiliates. The value of these benefits and what organizational and individual factors that may affect their value have not been explored. PURPOSE: This article explores the influence of organizational and individual factors on the value of resources offered by a prominent health care professional association. METHODOLOGY/APPROACH: Data from a national survey of hospital CEOs were combined with American Hospital Association data for descriptive statistics and regression analyses to examine the organizational and individual characteristics influencing the value of professional association affiliation. FINDINGS: Our research suggests that most hospital CEOs perceived value in the resources provided by their primary professional organization. In addition, both organizational and individual factors contributed to the perceived value of professional association affiliation. Significant organizational influences included hospital ownership and system membership, which were related to less importance and value from affiliation. Positive and significant individual characteristics included certification as an association fellow and CEOs who have a high value for coaching. Interestingly, men perceived less organizational value from affiliation and older CEOs saw less individual value. PRACTICAL IMPLICATIONS: Executives considering affiliating with a professional association can better understand how existing affiliates perceive and value the associations' benefits. In addition, executives and professional associations can be more informed how professional association affiliation is significantly influenced by organizational and individual characteristics. Individuals, organizations, and professional associations should be aware of the perceptions and differences among those who do and could avail themselves of professional association resources.

Physician-leaders and hospital performance: is there an association?

Although it has long been conjectured that having physicians in leadership positions is valuable for hospital performance, there is no published empirical work on the hypothesis. This cross-sectional study reports the first evidence. Data were collected on the top-100 U.S. hospitals in 2009, as identified by a widely-used media-generated ranking of quality, in three specialties: Cancer, Digestive Disorders, and Heart and Heart Surgery. The personal histories of the 300 chief executive officers of these hospitals were then traced by hand. The CEOs are classified into physicians and non-physician managers. The paper finds a strong positive association between the ranked quality of a hospital and whether the CEO is a physician or not (p < 0.001). This kind of cross-sectional evidence does not establish that physician-leaders outperform professional managers, but it is consistent with such claims and suggests that this area is now an important one for systematic future research.

Cargos de gestión en hospitales públicos madrileños y en colegios profesionales españoles. un análisis de género / Management positions in public hospitals of Madrid and Spanish professional associations. A gender analysis

Objetivo: analizar los cargos de gestión desde una perspectiva de género,en dos tipos de organizaciones: los hospitales públicos de la Comunidad de Madrid y las organizaciones colegiales de médicos y ATS/DUE. Material y método: estudio descriptivo transversal. Para el estudio en los hospitales se realizó un muestreo por cuotas, seleccionándose mediante consenso del grupo investigador 11 hospitales de los cuales se recogieron datos oficiales por encuesta directa a la dirección del centro y para las organizaciones colegiales, se accedió a las páginas web oficiales de todos los colegios provinciales de médicos y ATS/DUE españoles. Variables de estudio:sexo, categoría y comunidades autónomas.Resultados: la muestra incluyó a 30.909 trabajadores, 23% varones y 77% mujeres. El 54% de los cargos eran ocupados por varones y un 3% de las mujeres tenían cargo frente a un 13% de los varones. Dentro del personal sanitario no médico un 82% de los cargos eran ocupados por mujeres; en el personal sanitario médico, un 26% y en el personal no sanitario, un 44%.En los colegios médicos, un 20% de los puestos de las juntas directivas estaban ocupados por mujeres. En los colegios de Enfermería, las mujeres ocupaban el 58% de los puestos de las juntas directivas.Conclusiones: los resultados ponen de manifiesto la existencia de una clara desigualdad en el acceso a cargos de gestión de los centros de atención especializada de la red pública madrileña. De las tres categorías, la de personal sanitario no médico es la única en la que los cargos recaen mayoritariamente sobre mujeres. Respecto a los colegios profesionales de médicosy ATS/DUE, presentan desigualdades más acusadas aún, en cuanto a la representación de mujeres en las juntas de gobierno y en cuanto a la importancia de los cargos que ocupan dentro de las juntas (AU)

Objective: to analyse management positions from a gender perspective, in two types of organizations: public hospitals of the Community of Madrid and physician and health care aids/nursing university graduates associations.Material and method: cross-sectional descriptive study. Quota sampling was performed for the hospital-based study, and 11 hospitals were selected through consensus of the research team. Subsequently official data for these hospitals were collected from direct surveys administered to the centre’smanagement; as for the regional professional associations of physicians and health care aids/nursing university graduates, information was collected by accessing all of their official websites. Study variables: sex,category and autonomous communities.Results: the sample included 30.909 employees, 23% of which were males and 77% females. 54% of positions were occupied by males and 3% of female sheld positions versus 13% of males. Within the non-physician healthcare staff 82% of positions were occupied by women; in the medical health care staff, this percentage was 26%, and in non-health care staff, 44%. Inphysician professional associations, 20% of positions in boards of directors were occupied by women. In nursing associations, women occupied 58% of positions in the boards of directors. Conclusions: these results demonstrate the existence of a clearly unequaldistribution in the access to management positions in specialised care centres of Madrid’s public network. Of the three categories, non-medical healthcare staff is the only one in which management positions are held mainly by women. In regards to physician and health care aids/nursing university graduates professional associations, there are even more marked differen -ces in terms of female representation in governing boards and the importance of the positions they occupy within them (AU)

Responses of Massachusetts hospitals to a state mandate to collect race, ethnicity and language data from patients: a qualitative study.

BACKGROUND: A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals. METHODS: Thematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009. RESULTS: The number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state. CONCLUSIONS: The responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.