The Vanishing COO: Why Healthcare Systems Are Rethinking Their Second-in-Command
Nearly 40% of healthcare organizations report struggling with leadership pipeline development, according to a recent report by the American College of Healthcare Executives. This instability is now manifesting in unexpected ways, like the elimination of the Chief Operating Officer role – a move recently made by Oregon Health & Science University (OHSU). The decision, impacting long-time COO Joe Ness, isn’t an isolated incident, and signals a broader shift in how healthcare systems are structuring leadership to navigate increasing complexity and financial pressures.
A Cascade of Leadership Changes at OHSU
OHSU’s move to eliminate the **COO** role follows a period of significant leadership turnover. Joe Ness, who held the position since August 2018, was informed his responsibilities would be absorbed by other members of the OHSU Health leadership team, including the incoming CEO. This came after a tumultuous six-month period where two interim CEOs – John Hunter, MD, and Ann Madden Rice – each held the top spot for a remarkably short time. Mr. Ness’s departure, as he told Willamette Week, was framed as a redundancy, with his duties deemed coverable by existing staff.
Beyond OHSU: A Growing Trend in Healthcare Leadership
While OHSU’s situation is unique in its rapid succession of interim leadership, the elimination of the COO position is part of a growing trend. Several factors are driving this change. Firstly, the increasing emphasis on integrated care models demands leaders with broader, system-wide perspectives. Traditionally, the COO focused on internal operations, while the CEO concentrated on external strategy. However, modern healthcare requires seamless coordination between clinical, financial, and technological domains – blurring these lines.
The Rise of the ‘Integrated Leader’
Healthcare systems are increasingly seeking leaders who can bridge these silos. This has led to the creation of new roles – like Chief Strategy Officers and Chief Digital Officers – and a re-evaluation of existing ones. The COO role, often focused on efficiency and cost control, can sometimes be perceived as at odds with innovation and patient-centered care. Instead, organizations are looking for leaders who can champion both operational excellence *and* strategic growth.
Financial Pressures and Operational Efficiency
The financial realities facing healthcare are also playing a role. Rising costs, declining reimbursements, and increasing regulatory burdens are forcing organizations to streamline operations and eliminate redundancies. Eliminating the COO position can be seen as a cost-saving measure, particularly if those responsibilities can be effectively distributed among other executives. However, this strategy carries risks. Overburdening existing leaders can lead to burnout and decreased effectiveness.
The Impact of New Appointments: A Focus on People and Data
OHSU’s recent appointments of Shereef elnaal as MDAS President and Angela Glass as Executive Vice President and Chief People Officer suggest a strategic shift towards prioritizing physician alignment and employee well-being. These additions signal a recognition that a strong workforce and engaged physicians are critical to navigating the challenges ahead. Investing in people and fostering a positive organizational culture can be more impactful than simply optimizing operational processes.
Future Implications: Flattening Hierarchies and Empowering Teams
The trend of eliminating the COO role could accelerate a broader flattening of healthcare organizational hierarchies. As technology empowers frontline staff and data analytics provide greater visibility into operations, the need for layers of middle management diminishes. Successful healthcare organizations will be those that can empower teams, foster collaboration, and embrace agile decision-making. This requires a shift in leadership style – from command-and-control to coaching and facilitation.
The future of healthcare leadership isn’t about eliminating roles entirely, but about redefining them. The traditional COO model may be becoming obsolete, replaced by a more dynamic and integrated approach that prioritizes strategic alignment, employee engagement, and data-driven decision-making. What are your predictions for the evolving role of the COO in healthcare? Share your thoughts in the comments below!
