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Delegator vs. Engaging CFO: Leadership Styles in Rural Hospitals & Why the Right Choice Matters

August 22, 2023    •    12 min read
CFO in Rural Hospital

Rural hospitals present unique dynamics governed by their smaller, close-knit teams, limited resources, and the imperative to address specific community needs. In such a setting, the role of a Chief Financial Officer (CFO) becomes pivotal. Their leadership style significantly influences the hospital’s financial stability, operational efficiency, and staff morale.

In this examination, we probe into two primary CFO leadership styles, the well-established ‘Delegator’ and the increasingly recognized ‘Engaging CFO.’ Each leadership type carries its distinct strengths and potential challenges. The Delegator CFO, renowned for task assignment and oversight, encourages staff growth and permits a strategic focus on big-picture issues. However, small team sizes at rural hospitals mean this style might need to be adapted.

Conversely, the Engaging CFO, characterized by a hands-on approach and personal investment in the team, builds strong team unity and is generally well-suited to the rural hospital environment. Still, this style could potentially risk losing perspective of overarching strategic goals amidst the day-to-day details.

Throughout this exploration, the focus is not merely to outline these leadership styles. Instead, the aim is to provide you with a nuanced understanding of how these styles function within the context of rural hospitals. This includes examining each style’s benefits and challenges in this unique environment and discussing how each can be adapted to serve a rural hospital setting better.

As we journey through this topic, we hope to offer valuable insights into the critical role of CFOs in rural hospitals and the influence of their leadership style on the hospital’s success. With healthcare finance expertise and an adaptive leadership approach, CFOs can drive stability and growth even amidst the intricacies of rural hospital operations.

The Delegator CFO in Rural Hospitals

The Delegator CFO embraces a leadership style that emphasizes task assignment and monitoring results. This approach plays a critical role in empowering staff, fostering their growth, and freeing up the CFO to focus on the bigger picture. However, the unique demands and characteristics of rural hospitals may challenge this style of leadership:

Positives of the Delegator CFO in Rural Hospitals

  • Staff Empowerment: The Delegator CFO entrusts staff with responsibilities and the autonomy to make decisions, boosting their confidence and performance. This allows staff to showcase their capabilities and enhances their professional growth.
  • Skill Development: By enabling team members to take charge of tasks, the Delegator CFO creates opportunities for staff to enhance their skills and develop subject matter expertise. The exposure and learning accelerates their knowledge.
  • Strategic Focus: The Delegator CFO can concentrate on vital long-term planning and strategic initiatives, promoting sustainable growth and innovation. Without day-to-day demands, they can dedicate time to high-impact projects.

Challenges for the Delegator CFO in Rural Hospitals

Rural hospitals face unique challenges due to their smaller and closer-knit finance teams, limited resources, and reliance on every team member to contribute. These factors can expose some weaknesses of the delegating style:

  • Smaller Team Sizes: With fewer finance team members available, a Delegator CFO may struggle to assign tasks effectively, potentially overloading some staff members. This could spur frustration and burnout.
  • Hands-On Work: In a rural hospital setting, everyone must actively contribute to financial projects. The Delegator CFO’s inclination to step back from hands-on work may create a gap in the team’s operational efforts that needs filling.
  • Limited Support: The nature of small and close-knit finance teams might not always afford adequate support and supervision for delegated work. This can impact quality as well as team morale.
  • Communication Disconnect: Insufficient communication and lack of personal involvement may risk weakening the sense of unity, trust, and transparency in a small rural team. This is a danger given the high-touch culture of rural hospitals.

Finding the Balance for the Delegator CFO

While the Delegator CFO’s leadership style has its merits, the unique demands of rural hospitals might require adaptation or even a shift towards a more engaged approach. Ways for the Delegator CFO to find an optimal balance include:

  • Set clear expectations for delegated tasks, provide hands-on training where needed, and implement strong oversight measures. Tight project management ensures quality work by smaller teams.
  • Schedule regular one-on-one check-ins with direct reports to strengthen communication channels and relationship-building. This fosters openness.
  • Demonstrate approachability and availability to have staff feel comfortable seeking support when roadblocks arise. An open-door policy promotes transparency.
  • Remain closely aware of team workload distribution and watch for any signs of overwhelm. Re-evaluate and adjust delegation as required to prevent burnout.
  • Participate selectively in hands-on components of vital projects to signal leadership commitment to the team. This fills any execution gaps.
  • Openly communicate the thought process and vision behind major decisions to build trust and unity. Celebrate team achievements frequently to motivate and bring together the rural hospital finance team.

When to Call in the Delegator CFO

The Delegator CFO can be highly effective in larger organizations or settings with greater operational complexity and team sizes. Their emphasis on delegation and strategic oversight works well when the following conditions exist:

  • Sufficiently large finance team size to distribute responsibilities and tasks, without overburdening staff. This provides room for delegation.
  • Highly capable and experienced talent that can take on delegated duties independently with minimal oversight. This minimizes quality risks.
  • Complex organizational structures requiring distributed management and oversight across locations, departments and specialties. The CFO cannot tackle this alone.
  • Critical need for the CFO to devote time to high-level initiatives like mergers, acquisitions, long-term forecasting and strategic planning. Delegation liberates their schedule.

In such environments, the Delegator CFO successfully empowers their team, enables skill development, and maintains a broad operational perspective. This enables them to focus on growth and innovation initiatives.

However, rural hospitals often face limitations in team size and organizational complexity. Therefore, while the Delegator CFO offers valuable strengths, their approach requires adaptation to the rural hospital context. Astutely blending delegation and oversight with engagement, direct mentorship, and hands-on participation helps them optimize their leadership in rural hospitals.

The Engaging CFO in Rural Hospitals

While the Delegator CFO model faces some adaptation challenges in rural hospitals, the Engaging CFO presents an alternative approach more seamlessly aligned with rural healthcare environments. This emerging leadership style is characterized by full involvement in day-to-day operations, close relationships with the team, and a hands-on, mentoring-focused philosophy.

The Engaging CFO stands in contrast to the more traditional delegator archetype, where the CFO takes a step back from daily activities to focus on strategy and oversight. However, the intimate nature of rural hospitals, where smaller teams tackle wide-ranging demands, calls for a CFO who can roll up their sleeves alongside their direct reports. The Engaging CFO fills this need, providing both financial leadership and active participative management.

Beyond just being present, the Engaging CFO strives to foster strong interpersonal relationships, transparency, and a culture of collaboration and development. They recognize that in the fast-paced rural hospital environment, ensuring staff feel valued, supported and communicated with is crucial for organizational outcomes.

The Engaging CFO’s signature traits, unpacked below, make them well-positioned to harness the opportunities of smaller rural teams while mitigating common pitfalls through their participative leadership. Their approach allows them to translate their financial expertise into impact tailored for the rural healthcare environment.

In contrast to the Delegator CFO, the Engaging CFO directly participates in the hospital’s daily operations alongside their team. Their leadership approach displays several signature traits that make this style well-suited for rural hospitals:

  • Transformational Leaders: Engaging CFOs motivate teams towards a shared vision, maintaining focus on broader organizational purpose rather than just daily tasks and siloed goals.
  • Inclusive Decision-Makers: They actively involve their team in key decisions rather than making unilateral calls. This allows them to integrate diverse perspectives and build buy-in.
  • Hands-On Mentors: Beyond just managing, Engaging CFOs provide personal guidance to develop team members’ skills, experience and confidence.
  • Active Listeners: Excellent listening ability allows them to deeply grasp issues from their team’s point of view, facilitating stronger relations.
  • Transparent Communicators: They openly convey expectations, provide constructive feedback, acknowledge achievements, and address difficult topics. This nurtures trust and respect.
  • Empathetic Leaders: Understanding team members’ needs inside and outside of work helps build a caring, trusting environment where staff feel valued as individuals.
  • Lead by Example: They model integrity, work ethic, accountability and other ideals for their team, setting the tone for organizational culture.

This hands-on approach enhances communication, quality control, and team unity – critical factors in rural hospitals. However, potential drawbacks like micromanagement must also be managed. When executed strategically, the Engaging CFO’s leadership can significantly benefit rural hospitals.

The Influence of the Engaging CFO in Rural Hospitals

In rural hospitals, operating under unique circumstances of closer community ties and smaller team sizes, the Engaging CFO assumes a pivotal role. Their hands-on approach and commitment to personal engagement make them well-suited to capitalize on the opportunities and overcome the challenges that rural hospitals present:

Community Awareness and Sensitivity

The Engaging CFO recognizes that rural hospitals serve tight-knit communities, where services align closely with local needs. Their hands-on involvement enables them to actively ensure financial operations match community priorities, securing both short and long-term fiscal health and sustainability.

Proactive Problem-Solving

The high level of engagement of the Engaging CFO allows them to detect issues early before they escalate. Their familiarity with ground-level operations provides a valuable vantage point to identify threats proactively. This permits timely and preemptive resolution, avoiding disruptions to hospital operations.

Fostering Unity and Productivity

The smaller team sizes typical for rural hospitals require committed leadership to function optimally. The Engaging CFO’s active participation fosters strong unity, trust, and a shared sense of purpose. This motivates the team, improving productivity and fulfillment despite limited resources.

Enhancing Quality of Decision-Making

The Engaging CFO champions collaborative decision-making, a significant advantage for rural hospitals. With major decisions carrying more weight in resource-constrained settings, collective intelligence and examination from all angles yields more nuanced and balanced outcomes.

Supporting Staff Resilience

The heavy demands on time and resources for rural hospital staff can slowly impact resilience and morale over time if not adequately managed. The Engaging CFO’s strong rapport, transparent communication, and empathetic leadership helps bolster the team’s mental resilience to combat burnout.

Overcoming Challenges

While the Engaging CFO offers multiple benefits, they must also remain alert to potential drawbacks of over-involvement like:

  • Micromanagement: The Engaging CFO must empower staff with adequate autonomy and resist managing minor details. This maintains operational sanity while still being available to contribute hands-on.
  • Losing Strategic Focus: Remaining involved at the ground-level must not completely distract the CFO from vital high-level planning and oversight. They must strike a balance between engagement and strategy.
  • Role Confusion: The CFO must remain in a clear leadership position and avoid taking on too many tactical responsibilities outside the CFO domain. This helps maintain role clarity.

The skilled Engaging CFO balances engaged participation with strategic prioritization, micromanagement avoidance, and upholding distinct leadership boundaries. They blend the detail-orientation of hands-on leadership with top-level strategic perspective. This fine balance is key to maximizing the value of an engaging style in rural hospitals.

Hiring an Engaging CFO for a Rural Hospital

Attracting and selecting the right Engaging CFO can significantly uplift rural hospital performance across financial stability, operational flow, staff success and community alignment. Some key strategies include:

Defining Role Requirements

Carefully outline the must-have experience, skills and qualities for an Engaging CFO. Consider requirements such as:

  • Extensive rural or small-scale healthcare financial management background
  • Demonstrated ability to lead, motivate and constructively engage small, intimate teams
  • Strong interpersonal, listening and communication skills
  • Passion for community-centric decision making beyond dollars and cents
  • Strategic thinking abilities alongside hands-on financial operations involvement
  • Healthcare finance certifications to reinforce credibility

Advertising and Networking

Prominently highlight the unique nature of the rural hospital CFO role to attract candidates inherently suited for high-engagement operating models. Tap professional networks to source potential hires with a track record of engaging leadership.

Evaluating Candidate Fit

Thoroughly examine candidate backgrounds, work styles and motivations to determine fit. Ask probing interview questions that provide insight into their people management approach, communication practices, hands-on involvement, relationship-building skill, and other markers of an engaging leader.

Assessing Leadership Style

Look for telling indicators throughout the hiring process that signal a candidate’s natural alignment with engaging leadership:

  • Passion for mentorship and investing in professional growth of others
  • Ability to adapt leadership approach based on diverse settings and contexts
  • Interpersonal awareness, emotional intelligence and commitment to understanding team needs
  • Focus on community impact and alignment beyond purely financial returns
  • Proactive and solutions-oriented thinking with financial ingenuity

The right Engaging CFO aligns leadership style, experience and sensibilities with the rural hospital environment to drive financial, operational and community gains. An informed hiring approach is vital to securing this pivotal leadership role.


Rural hospitals call for discerning leadership adept at thriving within unique constraints of smaller teams, scarce resources and community intricacies. The Engaging CFO, with their active involvement, relationship focus and hands-on approach emerges as well-positioned to address these dynamics. Still, adapting their style where necessary and maintaining strategic perspective remains vital. A nuanced understanding of the rural hospital landscape allows CFOs to tailor their leadership approach, advancing stability, efficiency and service quality within these settings. With astute self-assessment and adaptation, CFOs can become the engaging, forward-thinking leaders their rural hospitals need.

Gregory Brickner

Results Fanatic®


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