When to Bring in a Fractional CMO or CGOA CEO’s Case for Smarter Growth Leadership
SEPTEMBER 2025
When to Bring in a Fractional Executive
A CEO’s Case for Smarter Growth Leadership
BY PAULA SERIOS
60-second Executive Brief
Fractional leadership closes the growth gap faster than traditional hiring.
In an environment where margins are under siege and boards expect results in 90 days, waiting months for a permanent executive isn’t viable. Fractional CMOs and CGOs embed within weeks, bringing tested playbooks, financial acumen, and governance-ready reporting that compress time-to-impact and stabilize marketing performance during leadership transitions or growth inflection points.
Fractional doesn’t replace—it amplifies.
The most effective fractional engagements don’t fill vacancies; they partner with sitting CMOs to multiply impact, eliminate stranded spend, and elevate strategy to board pace. Their independence from internal politics allows them to challenge assumptions, accelerate execution, and create finance-grade clarity—turning marketing into a measurable growth system, not a cost center.
The 90-day value window proves performance, not promises.
Fractional executives deliver results aligned with board and investor cadence: uncovering inefficiencies in month one, activating growth systems in month two, and producing CFO-ready scoreboards by month three. Within a single quarter, they reframe marketing from expenditure to evidence-backed margin protection, giving CEOs and boards what they value most—proof, not promises.
WHY THIS MATTERS NOW
Margins are under pressure from every direction—rising labor costs, supply inflation, and payer demands. On top of that, patient behavior has shifted dramatically. One in five changed providers last year, often citing frustration with access. Nearly nine out of ten now expect 24/7 scheduling, yet most health systems still lag behind. Reputation is no longer optional: more than 86% of consumers check reviews, and many will not consider providers rated under four stars.
These are not marketing “soft metrics.” They are hard economics. Every access failure, every scheduling gap, every reduction in reputation velocity inflates acquisition costs and erodes contribution margin.
Executive Takeaway:
Patients are voting with their feet. If access and reputation aren’t fixed, no amount of advertising will save margin.
THE LEADERSHIP GAP
Even when CEOs recognize the challenge, the math of traditional hiring works against them. The average healthcare CMO lasts just over four years. Each transition restarts strategy and adds months of ramp-up time. Executive searches stretch 90 to 120 days, leaving organizations without senior leadership for nearly half a year at a time when boards demand progress within a quarter.
Fractional CMOs and CGOs close this gap. They can step in within weeks, bringing proven playbooks and immediate clarity. Importantly, they are not limited to filling empty chairs. Many of the most effective deployments are alongside sitting CMOs, adding an external point of view, accelerating strategy, and relieving internal teams so leaders can deliver results at board pace.
Executive Takeaway:
Fractional doesn’t replace—it accelerates. It strengthens leadership already in place and compresses time-to-impact.
BEYOND COST SAVINGS
The appeal of fractional leadership is not only that it costs less—though reducing executive overhead by 40–60% is meaningful. The real value is leverage. Fractional leaders pay for themselves by exposing stranded spend, redeploying dollars toward high-yield channels, and converting marketing from a cost center into a growth engine.
Because they are not tied to legacy politics, they bring perspective unclouded by internal bias. They can stress-test assumptions, validate or reframe growth strategies, and push execution faster than traditional models allow. And when paired with sitting CMOs, they multiply impact—providing both fresh insight and additional bandwidth without undermining authority.
Boards don’t respond to anecdotes. They respond to evidence. Fractional leaders give CEOs finance-ready dashboards that tie marketing metrics directly to contribution margin, payback periods, and unit economics. That reframes the conversation at the governance table from “what we spent” to “what we earned.”
THE 90-DAY VALUE WINDOW
Speed is the defining feature of fractional leadership. Within the first month, these executives surface wasted spend, uncover quick wins, and reframe growth opportunities. By the second, they are activating brand-demand-performance playbooks and breaking down silos across marketing, sales, and service. By the third, CEOs have a single scoreboard in hand—board-ready proof of how marketing dollars protect and expand margin.
The cadence matters. Boards and investors don’t wait a year for evidence. They expect progress inside a quarter. Fractional leaders are engineered to deliver on that timeline.
Executive Takeaway:
In 90 days, fractional leaders deliver what boards value most—proof, not promises.
A CASE IN POINT
One recent example we've seen of this impact was at a mid-market health system, with an overloaded but capable CMO, who brought in a fractional CGO to accelerate impact. Within 90 days, the partnership uncovered nearly $1 million in stranded vendor and martech spend, tied KPIs directly to contribution margin, and launched a reputation velocity initiative that drove an 18% lift in patient conversions.
The internal CMO remained at the helm, but the fractional partner doubled execution speed and provided board-ready reporting. The result was not a competing voice in the C-suite, but a stronger one—able to show, with confidence, that marketing spend was fueling margin protection.
Why CEOs Should Care
Fractional CMOs and CGOs are not staff hires. They are strategic levers CEOs can pull when boards demand faster results with less overhead. They provide economic clarity, governance readiness, and leadership agility at a fraction of the cost and time. And by partnering with internal leaders rather than displacing them, they de-risk growth while amplifying results.
Closing Case for Change
Fractional leadership is not a stopgap. It is a structural answer to healthcare’s margin crisis. It lowers executive overhead while delivering enterprise-grade leadership. It accelerates sitting CMOs, stabilizes organizations in transition, and reframes marketing as a system accountable for contribution.
Executive Takeaway:
Executive Takeaway: The smartest move this year may not be who you hire full-time, but how you uplevel growth leadership.
A Private Signals Session
SPIRTO offers a 60-minute, closed-door CEO briefing designed to accelerate this growth shift: the SPIRTO Signal Session.
Within 72 hours of scheduling, leaders receive a Margin Protection Scoreboard, a one-page executive dashboard that reframes marketing as a margin driver instead of a cost center.
Why CEOs take this meeting: it reframes the discussion. Instead of debating cuts, the board sees a growth cycle at work—one engineered to protect margin.
Schedule a Private SPIRTO Signal Session, here.
About Paula Serios & SPIRTO
Paula Serios, Founder + CEO of SPIRTO, is a 35+ year healthcare operator who has led marketing for $175M–$30B organizations and partnered with more than 100 healthcare brands to drive up to 3× revenue lifts through M&A, value-based care, and digital transformation.
At SPIRTO, she leads fractional CMO/CGO teams and the AI-enabled Growth Lab, an executive-led system that connects brand, demand, and access into one accountable growth engine—delivering board-ready ROI plans in 90 days for mid-market health systems and plans.