TheStruggleforPoweratMidwestHospitalSystem

ByTracyH.Porter

Midwest Hospital System, a large 500-bed hospital, with 5 satellite locations and over 5,000 employees, will be seeking a new Chief Executive Officer as Mr. Tom Jones, the current CEO, retires by the end of the year. Since the announcement of Mr. Jones'pending retirement a few months ago, there has been a level of intensity within the organization due to many interested candidatesjockeyingtobeconsideredforthismostdesirableposition.Overthepastmonth,two candidates have risen to the forefront as the top contenders for Mr. Jones'jobDonna Harvard and Steven Evans.

Donna Harvard currently serves as CFO of the health system and has worked her way up through the ranks during the past 20 years. Harvard, with an MBA, has been the genius behind thecompany'sfinancialsuccessinrecentyearsandpossessesathoroughunderstandingofthe inner workings of the organization. Recently she completed a second graduate degree in healthcare administration and has spent numerous hours trying to learn about the system's various clinical departments, which are the only areas she feels somewhat at a loss.Those who support Harvard for the CEO position describe her as "a true professional with a deep understanding of the needs of the hospital in both the short and long runs." The current CEO had been overheard saying that "Harvard is the candidate with the most experience with regard torunningahospital."Still,thelackofclinical experiencemaybeanissue,andwhenHarvardis questioned on this issue, she states, "I will trust the health system's medical staff to handle that part of the job. I won't tell them how to do their job if they don't tell me how to do mine."

The second candidate, Steven Evans, is relatively new to the healthcare industry, receiving his medical degree 2 years ago. Evans is less experienced than Harvard, but as a physician, he appeals to the system's medical staff. Many believe his medical training and other credentials will be valuable assets for the CEO position. Evans'supporters state that "he is the only candidate who is capable of understanding the central purpose of the institution." However, during his time with the health system, Evans has only worked in the Emergency Department with little or no experience with the business side of health care. When questioned on this topic, Evans relates, "I went to medical school so I am confident I can learn the business side of running this hospital. It will only take a short while for me to bring myself current on that information." In addition to being a physician, Evans is also well liked within the hospital.This is clear as he walks through the hospital with everyone greeting him with a smile and handshake. Oneofthenurseswasoverheardsaying,"EveryonelovesDr.Evans.Heisn'tthetypeofperson who thinks he is better than us. He is just one of us."

It has become apparent to Mr. Jones that there is an apparent divide between the clinical and the nonclinical sides of the health system. The clinical members of the organization see the administrators as "clueless people who have no real grip on the central focus of this hospital. They (administration) are here to support us but often they think they are more important than they actually are."The nonclinical (administrative) members of the organization see the clinical employeesas"notfocusedonthebottomlineandlackinganysenseoffiscalresponsibility."An "us against them" mentality has become the main thrust of choosing the best candidate. Mr.

JoneswantstheBoardofDirectorstomaketherightdecisionaboutwhoshouldsucceed him.

WhichcandidateshouldherecommendtotheBoard?Whichcandidatewouldbebestforthe health system's future?

CASESTUDYDISCUSSIONQUESTIONS

1. French&Ravenintroducefivebasesofpower:Coercive,Reward,Legitimate,Referent,and Expert.
   • CoercivePower:Theabilitytoforcesomeonetodosomethingthathe/shedoesnot desire to do.
   • RewardPower:Theabilitytograntanotherpersonthingsthatpersondesiresorto remove or decrease things the person does not desire.
   • LegitimatePower:Theabilitytotheabilitytoadministertoanothercertainfeelingsof obligation or the notion of responsibility
   • ReferentPower:Theabilitytoadministertoanotherasenseofpersonalacceptanceor personal approval.
   • ExpertPower:Theabilitytoadministertoanotherinformation,knowledge,orexpertise. Which of French and Raven's power bases does each of the candidates exhibit?

1. Howdoyoubelievetheclinicalandnonclinicalemployeesviewthepowerofeach candidate?

1. Basedonwhatyouhavelearnedabouteachcandidate,whichindividualwouldyouchoose as the new CEO? Why?