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Getting Our Leaders on CEO Track Crucial for Behavioral Health's Future
Some people can be effective leaders in any organization. We often do not know which ones. Few of us have been tested in this way. This is an increasingly important issue as our field transitions from being independent to becoming part of the larger healthcare system. We will be competing for resources inside these corporations. It will help if some of our leaders get promoted into these C-suites.
This will not happen naturally. We are not seen as being like the rest of medicine. Some of our patients and our treatments (like therapy) are different. Self-disclosure is a scary practice for many people. Our leaders will need to push themselves forward as candidates for big healthcare jobs because they are likely to be ignored otherwise. They must show they can be effective in any organization.
Healthcare has much to gain from our stigmatized, chronically underfunded field. Long underestimated, our field is not primed to be a powerful constituency within healthcare. Yet our behavioral skills represent a dimension of care that has barely been tapped in the medical world. Behavior impacts every diagnosed medical condition, either by maintaining illness or health. Many now see this.
Physicians have a limited understanding of behavior change. They tend to instruct or cajole patients. The behavioral dimension of healthcare represents a great opportunity for improving clinical outcomes, but our field will not gain influence based on stories or statistics. We need champions in positions of power, or better yet, our leaders need to rise to positions of authority in the larger healthcare industry.
It is time for behavioral healthcare executives to begin talking about this challenge. Many have succeeded in this field and could excel in a big healthcare job, but they need to get on the career track toward that role. This is not complicated but requires flexibility and persistence. One needs to move into successively bigger jobs and in the process be willing to uproot and move to new cities.
Having an MD may be helpful for some positions, but an MBA and a strong understanding of finance is more essential. The greatest asset one can have is social support. That support is especially needed in the early part of this career path. Making the leap from behavioral health to a medical or general healthcare system is not easy. It will not happen without planning and encouragement.
Is this issue being exaggerated? It depends on 2 factors: how strongly one believes the larger healthcare industry will drive the fate of our field and how pivotal individual leaders might be in shaping history. If belief in these areas is high, then urgency is needed. Small support groups for leaders eager to make this leap should be forming now. Yet some will lack urgency based on hopeful signs in our field.
What gives some the sense that all is well? Witness the exciting new growth in our field—such as highly valued start-up companies, new networks recruiting clinicians, and new ventures selecting executives to lead them. The public’s awareness of our field is also growing. Celebrities are promoting the need for treatment, while politicians are boosting funding for our mental health and substance use disorder crises.
These optimistic trends are probably short-lived. Exorbitant valuations of our start-ups will likely fall. Provider networks will lose their luster as struggles inevitably emerge with affordable pricing and high quality. Stigma has defiantly survived celebrity disclosures for decades. Our funding is so deficient that sporadic, politically driven subsidies (due to COVID-19, overdoses, or suicides) will not change fundamentals.
Two wealthy institutions will endure—health plans and health systems—and our field will fare better if leaders in these companies fully know our value. Inserting our leaders into them will help. However, our leaders must convince executives in the healthcare industry of 2 things: that they are excellent managers and that they possess a unique vision of healthcare.
While vision is a secondary companion to leadership skills, our executives should promote the biopsychosocial (BPS) model as a paradigm shift. Despite some occasional, superficial support for this comprehensive approach to healthcare, it has never been the dominant model for care in this country. It could rise to that position with a leader who understands the centrality of behavior in health status.
The BPS model is generally misunderstood as validating the importance of its 3 domains. It is about the interconnectedness of these domains in every medical situation and how they impact one another. The biomedical approach has rewarded us with many treatments, and yet the impact of behavior is now undisputed, and socially driven health inequities are finally being recognized.
Top healthcare executives must see that we have excellent managers in our ranks who are ready to lead larger healthcare enterprises. Some people can be effective leaders in any organization.
Ed Jones, PhD is currently with ERJ Consulting, LLC and previously served as President at ValueOptions and Chief Clinical Officer at PacifiCare Behavioral Health.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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