Chief Health Officers Draw Attention

Since the pandemic began, Preeti Malani’s name has appeared in news articles, television segments and thousands of in-boxes. Her comments are consistent and confident. She debunks COVID-19 myths, provides updates on the University of Michigan’s pandemic response plans and urges students to get out of their rooms and spend time outside.

Malani is the chief health officer at the University of Michigan, a role she's held since 2017. She’s one of a small but growing number of chief health officers at colleges and universities. Malani, like many chief health officers, serves as the public face of the University of Michigan’s pandemic response.

As the pandemic drags on, some colleges have considered adding chief health officers to their executive teams. Their goal would be to lead campus health and safety strategies, build out connections with state and local hospitals, connect with health agencies, and communicate with credibility to students, employees and parents.

“There’s so much noise right now,” Malani said. “To have someone in that role who can say, ‘This is hard. We’re in the middle of a pandemic … but here are the things we can do. COVID-19 is not the only threat -- let’s not forget about X, Y and Z.’ That’s my weekly message.”

Colleges need someone who can speak with authority on health and pandemic-related topics, said Richard Skinner, senior consultant at Harris Search Associates and former president of Clayton State University in Atlanta. He recently co-wrote a white paper advocating for the inclusion of a chief health officer in college cabinets.

“For the president to say ‘I don’t know’ is the kiss of death,” Skinner said. It’s important for colleges to communicate that things are under control, and a chief health officer may do so more effectively than others.

Maintaining the trust of students, employees, parents and onlookers is crucial for a college’s success, said Larry Ladd, a senior consultant at the Association of Governing Boards of Universities and Colleges.

“Colleges and universities don’t have one owner -- everybody either owns it or thinks they own it,” he said. “So for a college to be successful, they have to maintain the trust of all the stakeholders."

Establishing a chief health officer also signifies to students, employees, parents and others that the college considers health a priority, Ladd said.

In the past, colleges have created other executive positions to demonstrate which issues or topics they consider most important, Ladd said. For example, a growing number of colleges have hired a chief diversity officer in recent years, as well as executive positions related to international outreach. In the last 20 years, colleges have prioritized information technology with chief information officers.

These positions don’t always stick. When the pandemic is in colleges’ rearview mirror, it’s unclear whether having a chief health officer will be as valuable as it has been this year.

Ladd recalled writing in the early 2000s about colleges’ demand for chief risk officers in the wake of the 2001 Enron scandal and resulting federal Sarbanes-Oxley Act, which was designed to improve corporate disclosures.

“Risk was a higher priority than it is now,” Ladd said. “Those came and went.”

Whether the CHO becomes a college fixture remains to be seen. Some faculty members can provide colleges with medical expertise, but the history of higher education proves that colleges sometimes permanently move from meeting needs with ad hoc faculty roles to formalized administrative roles.

Even librarians, considered a must-have at colleges and universities everywhere, weren’t dedicated staff members until the late 19th century, Ladd said. Before then, faculty members ran college libraries.

Bowling Green State University hired its new chief health officer, Ben Batey, in July in response to the pandemic, according to university spokesperson Alex Dominic Solis. Batey leads the university’s COVID-19 response team and counsels the president on health and wellness matters.

Like Malani, most of Batey’s work is externally facing, Solis said in an email. He works with local, regional and state health partners and agencies in crafting the university’s pandemic response. He also serves as a liaison between the university and local hospitals and health departments. Batey’s office is responsible for keeping students, parents, employees and alumni apprised of the university’s response to COVID-19.

Critics of the chief health officer position may argue that it contributes to administrative bloat. Higher education’s executive workforce has grown by more than 100 percent in 25 years, and executive positions are expensive, Skinner wrote in the white paper.

“I do expect at least some pushback,” Skinner said. “The type of person who would take this job is not going to be poorly paid, because they’re a physician.”

At Bowling Green State, Batey earns $128,000 per year. Michigan’s Malani makes about $250,000, although she noted her salary is based on her role as a full professor in the medical school. Chief health officers could get more expensive, Ladd said, as demand for the role rises.

But cash-strapped colleges may need to cut somewhere.

“I expect all C-suites will start to shrink, because the money is not there,” Ladd said.

For small liberal arts colleges, community colleges, regional universities and other institutions with comparatively small budgets, a chief health officer may never be in the cards. Some institutions have filled the role in other ways.

Monday was Brian Lenzmeier’s first day as president of Buena Vista University, a small, private university in Storm Lake, Iowa, with about 730 residential students. He is not new to the job -- he had been interim president since May after former president Joshua Merchant resigned.

Lenzmeier has a background in science and virology, making his appointment particularly fortuitous during a pandemic, he said. His background allows him to more easily evaluate and act on new research, and it also lends him credibility while speaking to parents, students, employees and outside parties about the pandemic.

Hiring a chief health officer at Buena Vista is not a high priority.

“I did have a conversation with the Board of Trustees, and one of the things we talked about is do we need somebody who is hired entirely to focus on the response to COVID?” Lenzmeier said. “We decided against bringing someone in, mainly to keep costs down but also because I can handle it.”

Colleges without the resources to bring on a chief health officer have other options, Ladd said. They can work with local and state health agencies, hire a health consultant, and partner with larger nearby institutions or academic medical centers.

After the pandemic passes, Malani hopes her visibility at the University of Michigan will help her make progress on other college health issues like vaccines, health-care equity and student mental health.

“I care deeply about the health of the community,” she said. “I feel like we’ve gone through this life-changing experience, and the integration is so great and the communication is so great that we might move the needle on other things."