On a Personal Note...

I guess it may have been apparent to a few that the new job in the Great American desert is not going well. When I took the job, it looked like a turn-around was well under way and the group was ready to establish a quality and improvement agenda.

I was wrong.

The CEO was fired six weeks into the job, the board is locked in a self-destructive lawsuit driven by ego and an attorney running for public office with a platform of attacking corruption in institutions.

The details of why I'm leaving this new job only sounds like sour grapes and so should be subject to a little self-editing. I have bad feelings about more than a couple of people, but they will fade in time. Hopefully not much dirt will stick as I dust myself off and move on.

CEO turnover at hospitals is 14% - 18% according to the ACHE. Secondary turnover (other executives leaving) is also high; 77% for CMO's. Competitors frequently take advantage of instability to poach senior executives, physicians and other key staff. Most CEO positions get filled within a year. The average tenure of a CEO is 5.5 years.

I can't find any references this morning, but out of a vague cloud of memory, I recall that CMO's last an average of 3 years. One of my colleagues tells me she had read it was 18 months!

This may seem strange to many folks in health care, but not so in the business world. The other kind of CMO (chief marketing officer) had an average tenure of 23 months in 2006.

So why do I do this? I am certainly asking myself the question as I read about Jay Parkinson's entrepreneurial approach to the health system.

I know that there is value in approaching health person by person, as in any form of medical practice. But enabling others to do the same is a matter of scale. I'm just thinking out loud here, but this health care system is not likely to be overhauled in its entirety, but rather incrementally. Even universal health care will only address the 14 - 18% of the population that really needs a little more help. We may or may not be reaching a tipping point that may or may not fundamentally change the way health care is delivered. There may or may not be disruptive technologies that will destroy the current health infrastructure.

Would you rather work within the system, outside the system or just chuck it all and keep seeing patients, giving up all semblance of an ability to influence the system or the health of populations? Or some combination of the above?

Fortunately my situation allows me the luxury of time to figure it out. The last thing you want is to jump from one bad job to another. So excuse me while I pursue the really important things in life and cruise out to the mountains in my Jeep for a little off-roading!