The Boardroom Just Admitted the Old Scorecard Doesn't Work Anymore

For twenty years, healthcare leadership had a formula. You ran a P&L, you managed a service line, you eventually got the COO title, and if the board liked what they saw, you got the corner office. The résumé did the talking.

That formula is breaking down, and not quietly. A recent piece in Becker's Hospital Review by Kristin Kuchno profiled three health system CEOs whose paths to the top look nothing alike: a transplant surgeon, an emergency medicine physician, and an HR executive who arrived at the role through personal loss and a career pivot nobody would have scripted for her. Dan Young, senior partner at executive search firm WittKieffer, put words to what boards are actually asking for now. It used to be about operational prowess, it used to be about business savvy, and now it's more about connectivity, he said, describing a leader's capacity to bring disparate stakeholders and ideas into alignment.

That's a striking admission coming from the people whose job is to read leadership talent for a living. The industry's own search consultants are saying the thing that used to get you hired isn't the thing that gets you hired anymore.

What the CEOs Actually Said

What's important is humility and empathy, said Dr. Marlon Levy, and he'd know. He spent most of his career as a transplant surgeon at VCU Health before the board asked him to run the whole system. When someone asked what he'd tell a younger leader chasing a CEO title, budgets never came up. Being able to put yourself in others' shoes and understand others' perspectives is really essential to being successful, regardless of your position, but including that of a chief executive.

Dr. Matthew Hanley took a different road to the same conclusion. Emergency medicine, then a few years in the private sector, then the top job at Northeast Georgia Health System. His answer, when Kuchno asked what actually matters, was direct. This is a service job, and if you're not service-oriented, go find something else to do, he said. We exist through and for our communities and for our patients.

Dr. Mandy Eaton's path looked different from both. She moved into the C-suite through human resources, a route that rarely leads to a corner office, and she's open about what led her there. Dealing with my grief gave me the courage to pivot in my career and to step into new places and new roles, she said, describing the period after her daughter's death. Now, as CEO of Memorial Health, she leans on a guiding principle: I believe that culture precedes strategy. And trust is really at the foundation of exceptional care delivery, as well as execution.

Why This Isn't a Healthcare Story

It's tempting to read this as a healthcare phenomenon: physicians in the C-suite, HR executives running hospital systems, boards getting comfortable with nontraditional pipelines. But the pattern underneath it isn't specific to healthcare at all. Any industry built on complex stakeholder ecosystems, tight margins, and a workforce that's tired of being managed by spreadsheet is running into the same wall. Boards everywhere are discovering that the leaders who can hit a number don't automatically know how to hold a room, absorb conflicting priorities, or make people want to follow them when the plan changes midstream. Operational competency answers can this person run the org chart. It has never answered will people trust this person when things go sideways.

This pattern isn't limited to hospitals. The skills that get someone promoted and the character that makes someone worth following once they're in the role have never been the same thing. Boards are finally naming the difference.

The Gap Boards Haven't Closed

Boards have changed what they select for. They haven't changed what they develop for.

Succession pipelines still run on functional exposure: run this division, own this P&L, get your ticket punched across three roles. Humility, empathy, and connectivity don't show up on that kind of scorecard, and most organizations don't have a real method for building them on purpose.

This is best described as a development gap, not a talent gap. Organizations are increasingly willing to say that character matters more than they used to acknowledge. Very few, though, have built a way to grow it, measure it, or hold a leader accountable to it the same way they'd hold someone accountable for missing a budget target.

Dr. Eaton put it plainly: The real work of a CEO is about staying brave enough to keep learning and growing. That's not a credential. It's a practice. And practice requires a way to see yourself clearly enough to know what to practice.

That gap is worth closing, in any industry, not just healthcare.

Source: Kuchno, K. "The nontraditional pathways to CEO gaining prominence." Becker's Hospital Review.

Gary L. Owens, Jr., EdD, BCC, PCC, is Vice President of Strategic Initiatives at Tilt365, a personality and character-strengths platform that helps leaders build the self-awareness competency alone can't provide. Learn more at tilt365.com/gary-owens.