I was at a meeting a while back with a room full of hospital CFOs. We discussed the great rift between financial leaders and clinical leaders and the idea to "take your hospital CFO to work." Isn't it ironic that there is often so much animosity / lack of understanding / lack of respect between them, and yet there probably hasn't been a time in the history of hospitals that they needed each other more?

Why can't clinical and financial leaders in hospitals really work together?

I think there are a lot of dynamics going on here, but let me just mention a few observations:
- A lot of clinical folks get promoted to management because they are clinically superb. They are thrown into the world of budgets, ROIs, and FTE calculations with no training. They go from peer to boss, with little training around management/leadership skills.
- A lot of financial folks sit in their cubicles looking at spreadsheets with little or no (or wrong) understanding of what really happens in the hospital. They only go to clinical folks when something is wrong, a budget is missed, a calculation is due.
- The role of financial leadership is changing. Bean counters no more, CFOs and financial leaders are often charged with strategy development, business expansion, revenue cycle, change management, and special projects. This ain't your father's CFO.
- Clinical Language vs. Finance Language is completely different. What does TPA mean to you? Third party claims administrator or tissue plasminogen activator?
- Finance is trained to see the aggregate, nursing is trained to focus on one individual at a time. The hospital needs both, but too often, this just leads to a superficial perspective: "those nurses have to get with the program or else we're going under" or "those finance boys don't understand the reality of patient care."

Anyway, I could go on and on about this, but I won't. The focus should be on how we can solve this problem. How much more effective would a hospital leadership team be if finance and clinical leaders could really align?

Going back to that meeting with CFOs, at the end of that meeting, one CFO mentioned that he was going to "take himself" to the clinical areas of his hospital right away. He shares what he did, what he learned, and what happened in this HFMA Blog post. After a few months, he gains the respect and camraderie of his clinical counterparts - they even surprised him with an certificate as an "honorary member of ER services." This is a great example of real leadership. Instead of "out-of-sight/mind" and "I'll-deal-with-this-later" attitude that just perpetuates so many inefficiencies, this CFO went after it head-on.