The CMOOO (or CMOO) Is Here. The Spelling Is Still Debated.
Organizations are finding success by combining CMO and COO roles—but the structure has to be right.
Healthcare CEOs have a fantasy candidate: an executive with deep clinical knowledge who runs a business with the same efficiency expected from a household appliance. The C-suite has a name for this figure: the CMOOO—a meld of the Chief Medical Officer and the Chief Operations Officer, or what some organizations are calling the Chief Clinical Officer. "We're absolutely seeing it," says Lisa Harrison, senior client partner in the healthcare practice at Korn Ferry. "Organizations are really trying to bridge the gap between clinical excellence and operational efficiency."
The trend dates back five years—which is about the time it takes for a healthcare trend to take hold. The impetus is straightforward: CMOs are increasingly being asked to take on more operational responsibility, says Li Ern Chen, MD, MS, market leader for the Physician Workforce Solutions practice at Korn Ferry. “In order for care delivery to work efficiently, clinical and care operations have to be completely aligned.” Both are core business drivers: patients return only when experience and outcomes are good, and the care delivery that drives this depends on both clinical and operational functions.
Make no mistake; the CMOOO role is undoubtedly greater than the sum of its parts. “They’re both very heavy roles,” says Jennifer Cano, director of the healthcare interim solutions practice at Korn Ferry. A strong CMOOO requires an even stronger team beneath them.
The best CMOOOs bring what Harrison calls multidimensional thinking. “It’s a blend of being really clinically grounded, but also having business acumen,” she says. CMOOOs understand both clinical and non-clinical functions, move fluidly across them, and create a culture of accountability. Hyper-collaboration is essential.
How the role is structured is as important as who fills it. In large, often heavily-merged health systems, a poorly designed CMOOO role can inadvertently block top leadership from driving clinical results. The combined role demands unusually clear accountability. “It must be straight-line accountability, not dotted-line,” says Harrison. Without that, the risks compound. A CMOOO who doesn't feel directly responsible for results is less motivated to collaborate—and over time, silos calcify.
Leadership development and executive coaching can help a new CMOOO assess the organization, identify gaps, and navigate the role's particular nuances. This is especially true for clinician executives, who may have reached the C-suite without ever receiving formal leadership training—and who may need to develop skills in areas like influence and conflict management that aren't taught in medical school. "People go through a lot of pain to learn this," says Cano. "You don't get respect just because you have the title—you have to learn how to lead."
The nightmare scenario, of course, is that after all that institutional investment—the challenging candidate search, the upskilling—the CMOOO leaves. "Then you have a gaping hole," says Harrison. Both the sunk costs and the vacancy costs can be significant. Many organizations hedge by keeping the CMO and COO as distinct roles paired in a dyad — and by adding rigorous assessment, training and coaching to the mix. But as the pressures on health systems intensify, the pull toward a single integrated leader only grows stronger. Though the CMOOO is hard to get right, in some organizations, it is also increasingly hard to do without.
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