Reorganizations have been considered by staff to be disruptive.  The frequent  reorganizations were mentioned by nearly all of the staff as a disruptive force, and have given them the impression that the senior management doesn’t have a clear path defined, and frankly, “don’t know what they’re doing”.  Although the “real” work does get done, it is felt that the company would be much more successful if they chose a definite management structure, and stuck to it.

Chief Operating Officer must be able to bridge the physician/administrator rift.  Most of the people we spoke to, including physicians, administrators, nurses and other staff, mentioned that there is a significant rift between the staff physicians and the administrative staff, and that this rift is far greater than the normal friction that exists between these two areas.  This rift is believed to be responsible for a number of lost opportunities and lost revenues.  The new COO must be able to walk on both sides of the management fence.  He or she will have to be able to ensure that the doctors and the administrators communicate in a new and productive fashion.

“In the early 1990’s, we were the black sheep, but now we are the darling of our parent company.  Many of our senior managers have moved into corporate positions with the parent in the last three years. We have lost very few people to other hospitals.” 

“We don't operate like a large company, even though our hospital is a division of a much larger system.  We operate more like a small, self-sustaining company with a unique culture. A big company mentality doesn't work here - the hard-nosed manager will not be successful; the people here will make that hard-nosed person fail.” 

“Our frequent reorganizations tend to be disruptive.  You often have to start from scratch.  You get the impression that management doesn't know what they're doing.  We don't seem to learn from the previous ones.”

“This is a relaxed organization.  You can actually have as much responsibility as you have the guts to wield.”

“We simply cannot afford to have a waiting list for physical therapy services and still expect to meet our financial targets.  We must hop right on this problem.”

“Our clinical directors are just that – clinical.  They’re really not managers.”

“An understanding of information technology will be critical.  I.T. is what will move us forward in the future.”

“This person needs to belong to both camps (all camps?).”

“This person must come from a business-like environment like our hospital.”

“This person must be able to walk on both sides of the management fence.  He or she will have to be able to ensure that the doctors and the administrators communicate.  In the past, there has been a brick wall between the two, especially in the past two years since Dr. Cottsworth came on board.”

“The person in this job must not only be accessible, but also very visible.  We have had the former, but certainly not the latter.”

“The COO must stay in touch with the staff and keep me in contact with the bigger picture.”

“The biggest obstacle this person will face is our culture.  It can be difficult to gain acceptance when coming from the outside. Most of our people have been here a long time.   The new people are compared to the long-tenured employees, who have a much better understanding of how this place works.”