Really Managing: The Work of Effective CEOs in Large Health Organizations. - book reviews

Healthcare Financial Management, April, 1989 by John P. deKoff

Really Managing: The Work of Effective CEOs in Large Health Organizations

From its title, this book would seem to be an insider's view of life at the top. But the almost verbatim interviews and observations of chief executive officers (CEDs) and their associates create more questions than answers.

The book is an academic text rather than a practitioner's source of information. The CEOs of the three medical centers and a health maintenance organization, all located in the northeast United States, were interviewed by the author, and then followed around for five consecutive working days. These CEOs also allowed other individuals to be interviewed, including subordinates, board members, and fellow administrators. The names of the CEOs and their institutions were changed (possibly to protect the innocent?).

The author is very candid early in the book by admitting that defining an effective CEO is difficult. The CEOs he describes all have five years or more experience in their current jobs. He also notes that two of these CEOs have subsequently been fired.

The heart of the book is the actual interviews with the CEOs. The reader is given some detailed insight into their thought processes, decision making rationales, and management philosophies. Unfortunately, this occupies less than 25 percent of the text.

Interviews with the CEOs' associates follow. The experienced healthcare professional will have some difficulty believing that a chief financial officer or chief operating officer is really baring his soul concerning the person that signs his paycheck. Interviews with board members and other do present some interesting and more credible opinions.

About 30 pages are devoted to the CEOs' "episodes of work" during the week they were observed by the author. This section reads like the work performance section of a time-monitoring system. These pages drive home the point that most managers are often interrupted, spend little time on individual items, and attend many meetings.

The author concludes by noting that it is important to periodically establish the expectations of both the CEO and the board of trustees. He also observes that what works for the CEO in one situation may or may not work in another situation, and that visible results are important.

This book is a must for those who want "hands-on" data. However, if you have attended either an administrative staff or department director meeting--save your money, you already know just about all of what is in this book.