Succession planning refers to a practice that helps organizations, academic or industrial and otherwise, to promote organizational cohesion and stability during a modification of the leadership structure. Succession planning allows an organization to remain dynamic and productive, and to quickly recover from such changes. Leadership transitions can be difficult in that they may occur suddenly or they involve a planned transition (death, retirement, new position, incarceration, etc.).
Succession planning is an important organizational action because: (1) it decreases the costs of recruitment and orientations; (2) allows more order in a leadership shift; (3) decreases time to filling job openings; (4) allows an organization to remain productive; (5) allows for development of necessary leadership competencies called for by temporal technological, economic and social forces; and (6) is a rational approach because it promotes efficient organizational evolution.
Here are some important facts in regard to academic medical centers and succession planning. There are currently more than 2000 U.S. medical school department chairs, and retention of first-time chairs in basic and clinical departments is in decline, which is a concern because of the need for stability in academic departments in this time of increasing regulation, decreasing reimbursement, and decreasing money available for research. The median range of a chair appointment is now 8.4 years in basic science and 7.9 years in clinical departments, and is declining. Succession planning allows an efficient and minimally interrupted change in leadership. Unfortunately, and of particular importance, is that interim leadership in academic departments has become common because turnover rates for chairs have become more frequent. Whether in basic science or clinical departments, 2/3 of new chairs in the U.S. come from within a department at the home institution. Many medial schools usually have one to two interim department chairs (July 2007). During the past thirty years five-year retention rates of basic science and clinical chairs have been around 70%.
In their 29-year retrospective review of department chair recruits and retention, Rayburn et al. reported the occurrence of 5,317 first time chair appointments. They point out that shorter chair tenure started in the 1990s, and that interim chairs serve from 1 to 8 years. Interim chairs must demonstrate the certain abilities (Table 1) if they are to be successful. It is important that a senior leadership chair should be assigned as a coach. We must remember that the high rates of attrition of chairs require the need for skilled interim leaders. This is something for which to strive, and always remember that being an interim chair is a great opportunity for women and other underrepresented minorities.
Although the corporate and academic environments differ, talent development is important, which is now being touted as succession development. Departments of human resources are now calling themselves departments of talent management, highlighting the need for succession planning, thereby increasing the possibility of promoting someone from inside that organization (Figure 1). This is important because promotions from inside the organization as opposed to outside recruits, allow a better economic return, and quite possibly better institutional/organizational performance. A survey of U.S. hospital chief executive officers in 2012, compared with those responses from 2007, identified a substantial increase in the importance of planning a smooth transition in leadership.
Two examples that differ from the American academic medicine perspective are Canada and the military. Canada, on one hand, approaches the challenge of department chairs a bit differently. Canadian medical schools have fixed term limits on Chairs, this is not so in the U.S. Even though fixed terms would seem to lead to smoother transitions, a fixed term would still require a need for succession planning. The success of the Canadian experience has been variable because sometimes they loose a number of chairs at one point in time. On the other hand, from the perspective of the military, their organizational structure is different from academia and has certain advantages. When they lose a leader, an immediate replacement is required. The military develops long term plans for identifying leaders by developing a list of qualified officers, and assigning them to billets that allow and encourage the development of skill sets, thereby giving high commands best chance at finding the “best fit” officer candidate. A built in disadvantage for academia is that academic medical centers/institutions do cannot make their faculty commit to a defined number of service years, i.e., they are not required to stay in a particular position for a particular length of time (as is demanded in the military).
Developing candidates begins with bench strength. Grooming your bench is very important. Chairs can develop candidates by providing leadership opportunities to those they deem qualified to assume such duties. If a chair had developed individuals with leadership experience and talent, these designees will be extremely helpful in times of transition. Institutions that place value on faculty development and various opportunities for advancement do better in times of transition; essentially they avoid most of the inherent chaos. A qualified internal candidate will lead to better transition and save on the costs of recruiting. Annual revaluations are an important for mentoring, tracking, and identifying faculty members who desire to be leaders/chairs. There are important clinical characteristics required for success (see table X). These characteristics should be addressed during annual evaluations because they will assist chairs in identifying who performs well and meets important expectations. Do not overlook the fact that it is very important to make mentorship of women and other minorities a high priority.
Turning now specifically to the topical area of the Dean. The Dean should engage chairs annually on the topic of interim chair and chair replacement to make sure the institution can make such transitions in a smooth manner. Department strengths, weaknesses, and threats should receive an annual update. Chairs must be aware of their “blind spots” when they argue with a Dean. Hopefully encounters that highlight differences of opinion will not result in negative experiences. Deans must have chairs must meet with her/him annually in order to discuss non-emergency succession planning.
The Dean must initiate any conversations regarding a chair’s performance and sustainability. If the chair has received a negative evaluation/performance summary, it will have to be addressed. However, the Dean must always be aware of family concerns, health problems, and any other problems that can be addressed. If a chair is replaced, the chair search and transition management is important; it must be transparent. It is important that the department remains stable, so it would be ideal if such an announcement occurred 6-12 months in advance of the chair’s departure. A chair not facing removal for cause should remain on the job until a new chair has arrived and is in place.
It is important that the faculty and department chairs understand a Dean’s perception and expectations regarding leadership transitions. Sometimes these perceptions and expectations are not entirely clear, and should be sought out or identified. Many deans require succession planning by their chairs and may even put it in their offer letters. In effect, the Dean may want a plan for identification of a replacement (in case of an emergency) assigned in advance. This plan needs to be updated yearly.
Search committees are important. While some chair candidates can be more interesting that others, a chair candidate has to understand the departments mission and the department’s place in the organization. Therefore, the search committee must also have those same understandings before starting the search for a replacement. Department faculty have to be consulted by the search committee as to their desired attributes in a chair, what goals should be addressed by the candidates, and transition concerns should be addressed. Do not forget that the final arbiter is the Dean. Furthermore, any chair that departs or is relieved of duties should respect the incoming chair’s position by keeping a distance from any decision-making and be very supportive of the transition.
Grooming your most likely candidates for selection as a future chair or interim chair to be competent is of paramount importance. The choice of a department chair or the selection of an interim chair must be exquisitely transparent and is something that cannot be compromised. Remember that appointing an interim chair is a great opportunity for women and other underrepresented minorities. Always plan carefully, select critically, in order to ensure stability and productivity of the department under transition.