Rising to the top

Pick up just about any book describing leadership traits, and you’ll see such terms as honest, trustworthy, high integrity, pragmatic, problem solver, effective decision maker, creative, innovative, results oriented, straight shooter, instills confidence, and persuasive. So it’s not surprising that these and similar terms greeted the appointment of Marilyn Tavenner as the new administrator for the Centers for Medicare & Medicaid Services (CMS) on May 15, 2013. Also not surprisingly, these are some of the same terms we associate with nurse leaders, along with puts patients first, competent, compassionate, and caring.

Tavenner proudly acknowledges her roots and experience as a nurse. She has been lauded for her outstanding leadership and management skills, her exemplary performance running the CMS as its interim leader, and her history of putting patient care first. Her appointment reinforces the commendable and effective characteristics of nurse leaders.

The role Tavenner has assumed is one of the most visible, influential, and at times controversial in health care. CMS commands more than $800 billion—about a third of all healthcare spending. No administrator had been confirmed since October 2006, when Mark McClellan resigned. In testament to the confidence in her proven ability to lead CMS, the Senate confirmed Tavenner’s nomination in a 91 to 7 vote, demonstrating bipartisan harmony (recently in short supply).

Tavenner’s picture appeared on the cover of the April 8, 2013 issue of Modern Healthcare, along with the title “In Charge” and the caption, “Visionary female healthcare executives are leading the way in an era of change.” Inside was the announcement of the “Top 25 Women in Healthcare for 2013.”

I confess I’m drawn to top 10, top 25, or top 100 lists to see who the healthcare tabloids consider to be the current stars. Some people view these lists as beauty contests. So was this just another popularity competition? No—this one struck me as decidedly different. Of Modern Healthcare’s 25 top women, nine are (or have been) registered nurses (RNs). In case you missed it, here’s a recap, in alphabetical order.

  • Maureen Bisognano, president and chief executive officer (CEO) of the Institute for Healthcare Improvement, a global leader in the vanguard of ensuring safer health care
  • Karen Daley, president of ANA, the principal U.S. nursing organization representing the interests of more than 3 million RNs
  • Patricia Hemingway Hall, president and CEO of Health Care Service Corporation, an organization with more than 1 million members that focuses on improving the health of children and families
  • Sister Carol Keehan, president and CEO of the Catholic Health Association, one of the largest not-for-profit groups of healthcare facilities
  • Sharon O’Keefe, president of the University of Chicago Medical Center, a leading academic medical center providing care to adults and children
  • Judith Persichilli, president and CEO of Catholic Health East, the nation’s third-largest not-for-profit health system
  • Marilyn Tavenner, CMS administrator, which oversees Medicare and Medicaid and is charged with implementing insurance reforms, health insurance exchanges, and other provisions of the Affordable Care Act
  • Mary Wakefield, administrator of the Health Resources and Services Administration (part of the Department of Health and Human Services), a diverse agency that focuses on training programs for the rural U.S. healthcare workforce and providing direct services to the underserved
  • Shirley Weis, chief administrative officer and vice president of the Mayo Clinic, a widely acclaimed institution that serves more than 1 million patients.

(View the complete cover story “Beyond the glass ceiling” at www.modernhealthcare.com/gallery/20130406/PHOTO/406009999/PH&Params=Itemnr=23&Template=galleryzoom)


In years past, some of these same nurses, and others, have reaped accolades for their leadership acumen and their importance to health care. Some also have made the gender-neutral list of the top 100 most influential leaders in health care. What’s different this time? The penetration of those who started as RNs. I applaud the nurses whose bios draw attention to that fact. We share in their successes and draw hope for continued growth of leadership ranks in health care, where nurses bring a humanistic, patient-centered approach to decision making and exhibit stewardship of both personal and financial well-being.

Another nurse, Carolyne K. Davis, was at the helm of the Health Care Financing Administration (the precursor to CMS) from 1981 to 1985, when the prospective payment system transformed Medicare. Tavenner now has the arduous responsibility of overseeing complete implementation of the Affordable Care Act, which has provoked acrimony but promises to address many healthcare inequalities. No wonder many think she is the right person for the job. If you have a difficult or near-impossible task, ask a nurse. It will be done, and done well.

One last request: If you’re a nurse leader who rises to national recognition, please don’t forget to proclaim your nursing roots. We need the world to know from whence you came.

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2 thoughts on “Rising to the top”

  1. Barbara Blakeney says:

    This has been such a long time coming but oh, how sweet it is. Thanks Pam for reminding us all to never forget our beginnings.

  2. Katherine M. Windsor, MSN, RN says:

    Inspiring article.

    The word “notoriety” should be exchanged for the more appropriate word, notability.

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