Traditionally, hospital CEOs are thought of as decision-makers—men and women who can digest a complex array of data and analysis, come up with an action plan, delegate the appropriate responsibilities and then take responsibility for the results when the board comes calling. And having a CEO with the ability to drive change by sheer force of personality is usually seen as a sign of institutional strength—I can't tell you how many stories I've written on successful hospital initiatives where a nurse, doctor or mid-level administrator told me, "This wouldn't have happened if not for the CEO," or, after a change in management, "This wouldn't have happened before, but now we've got the right person in charge."

Recently, though, I've come across an unmistakable trend in my reporting; the notion that thriving as a hospital CEO in an increasingly integrated, more patient-focused world, is less about leading from the top and more about building strong relationships with physicians and other community providers.

When I recently chatted with IHI CEO Maureen Bisognano, the subject of today's H&HN Daily podcast, she observed that back when she ran a hospital, her job was primarily focused on running the business of the institution: hiring staff, overseeing the physical plant and managing the financial operation. Gradually, the job of CEO evolved to more responsibility for clinical care. Now, Bisognano says, the job of hospital CEO is in the middle of another evolution—to deftly managing an increasingly broad set of relationships with physicians, patients and the wider community.

"Now it requires new negotiation and integration skills, and it requires seeing the patient across the entire continuum, so it requires collaboration and planning with entities that there's no legal connection to," Bisognano told me.

In his column for H&HN Daily yesterday, Dan Beckham, president of the health care consulting firm The Beckham Company, wrote that hospital boards, which "have seen the number of physicians on the payroll swell into the hundreds," want CEOs who have the people skills to manage all those new relationships.

"Relating productively with physicians is the core of a CEO's responsibilities," Beckham wrote.

As the old media saw goes, three makes a trend, and as I was putting the finishing touches on this piece, I happened to glance at the March cover article for the print edition of H&HN: "Simple Steps to Improve Relations with Physicians," which outlines informal steps hospital leaders can take to build better relationships with docs—including things as simple as asking personal questions and inviting troublesome employees out for coffee.

But I'm interested in hearing from you, the reader. Is running a hospital evolving from a strong leader who can drive change from the top to a more people-friendly relationship builder who can negotiate with physicians and lead with a more collaborative approach? E-mail your thoughts to