Beri Ridgeway, MD, is familiar with the variability and intensity of the chief of staff role.
"I work very long hours. The responsibilities are huge and wide-ranging," said Dr. Ridgeway, who fulfills the role at Cleveland Clinic.
"One day, for example, my activities shifted from recruiting an all-star physician, working with legal and strategy to develop an innovative program … and then [later] …supporting a team that lost a physician due an unexpected death. So every day is really different."
Dr. Ridgeway, who oversees about 5,000 physicians, scientists and physicians worldwide, joins leaders at Ascension, Mass General Brigham, NewYork-Presbyterian and Novant Health — among other health systems — in fulfilling the role. While there is no one path to the COS role, and duties are different at each organization, these leaders serve as links between daily operations and the senior leadership team. A post on Indeed describes it this way: "The chief of staff, also known as a chief executive assistant, is the beating heart of an organization, masterfully orchestrating various elements and uniting them into a cohesive whole."
Although it looks different across organizations, there is at least some indication that the role appears to be growing in prevalence. Between the 2019 and 2023 versions of a survey from consulting firm SullivanCotter, there was an estimated 65% increase in the number of health systems that submitted data on chiefs of staff.
"Chief of staff roles often help manage critical projects in support of the CEO," Tom Pavlik, managing principal at SullivanCotter, told Becker's. "The increasing prevalence of this role is likely related to the rising number of key strategic and operational initiatives healthcare leaders are managing during this tumultuous time in the industry."
Leaders who currently or previously fulfilled the role have acknowledged the challenges within healthcare and the position itself. Former chiefs of staff recently told McKinsey that the job requires reprioritization of interests and can be lonely, among other difficulties.
Dr. Ridgeway said she relates to the challenges mentioned to McKinsey, but she is happy to assume the responsibilities.
"You think through the last several years with COVID-19, the Great Resignation, our current financial challenges that face healthcare," she said. "We've, of course, reprioritized to deal with all of those things. And being a chief of staff is really thinking about how we create a sustainable infrastructure.
"Moving forward, with that as the backdrop, I am passionate about being the person at the table, the physician executive who will represent the voice of our doctors. I still practice. I still operate. I still see patients. So, I personally understand the day-to-day challenges that our workforce experiences."
To overcome the challenges that come her way, she focuses on perspective, according to Dr. Ridgeway.
"I take a clinical approach to my leadership and focus on the patient," she said. "There are a lot of mishaps that happen administratively. It's just a fact of even a well-organized enterprise and organization. But really focusing on the patient helps me understand what's really important and what's not."
Dr. Ridgeway also said she focuses on finding that win-win opportunity with different situations, carefully considers the expertise of other chiefs and department chairs, and keeps Cleveland Clinic's overall mission in mind.
"One of the big areas where I'm focusing is how we leverage all the talent within the organization to concretely share best practices across the entire footprint. And we have developed infrastructure to do that. … I never know exactly how [the chief of staff role] will evolve, [and] I know it will change [like] everything else. But there are things that also won't change, [such as the focus on being] the best place to receive care anywhere and best place to work in healthcare," she said.