The Board–CEO Power Shift in Life Sciences: How Governance Expectations Are Quietly Changing

I have noticed a shift in the past couple of years. It has been gradual, but now it is here in full force.

In my dialogues with life sciences CEOs, the narrative is more often than not circling around what I would term: A power shift between the board and top management. Again and again, they are voicing that over the past two to three years the dynamics in the boardroom has completely changed. Again and again, they are telling me that over the past two to three years the dynamics in the boardroom has completely changed. The shift is rarely announced, seldom formalised, and almost never framed as a critique of leadership. Yet it is felt, in the questions boards ask, the pace at which decisions are escalated, and the subtle rebalancing of authority between governance and management.

This is not a story of boards becoming hostile or CEOs losing relevance. It is a story of governance adapting to a fundamentally altered risk landscape, and of leadership expectations evolving faster than many CEOs realise.

From stewardship to intervention

Historically, the board–CEO relationship in life sciences has been anchored in a clear division of labour. Boards oversaw strategy, capital, and executive succession; CEOs executed, innovated, and carried the organisation forward. Tension existed, but roles were understood. Today, that boundary is less stable.

Boards are becoming more operationally assertive, particularly in areas that sit close to enterprise risk: capital allocation, portfolio prioritisation, leadership resilience, and downside protection. This assertiveness is often framed as “support,” more check-ins, more scenario discussions, more external validation, but in practice it can feel like a quiet step from oversight into control.

Importantly, this shift is rarely driven by mistrust of the CEO. It is driven by external pressure. Investor scrutiny has intensified. Regulatory exposure has expanded. Clinical, geopolitical, and capital-market uncertainty have compressed decision cycles. Boards themselves feel more exposed, and their behaviour reflects that exposure.

As one experienced chair put it: “Board risk has changed. So board behaviour has changed.”

The new board lens: Downside before upside

One of the most significant changes CEOs encounter is a reordering of board priorities. Where boards once leaned into long-term opportunity narratives and scientific optionality, they now start with downside questions.

What happens if this fails? What breaks first? What would we stop? What are we implicitly betting the company on?

Optimism without contingency is increasingly treated as a risk signal. A compelling vision is no longer sufficient unless paired with credible failure paths, kill criteria, and cash runway realism.

For CEOs, this can feel like a loss of strategic oxygen, a sense that ambition is being diluted. For boards, it is often experienced as fiduciary discipline. The gap between those perceptions is where governance tension begins.

Earlier, deeper, and more continuous involvement

Another quiet change is the rhythm of board engagement. Formal quarterly meetings no longer contain the full governance conversation. Ad hoc calls, informal check-ins with individual directors, and faster escalation expectations are now common.

On paper, this reflects alignment and partnership. In practice, many CEOs experience it as pressure, particularly when individual board members begin to probe operational detail or request early views on decisions that historically sat firmly with management. The intent, again, is rarely control. Boards want fewer surprises and earlier discomfort. They want visibility before issues become material. But without explicit recalibration, increased involvement can blur decision rights and erode clarity around who owns what.

Succession and resilience as live topics

Perhaps the most sensitive shift is the way boards now approach succession and CEO resilience. What was once a future or crisis-only discussion has moved into routine risk management.

Boards are quietly stress-testing:

• decision-making under sustained pressure,

• emotional steadiness in uncertainty,

• bench strength and leadership depth.

Succession planning is raised hypothetically, framed as prudence, but tracked seriously. Many CEOs are surprised not by the topic itself, but by how early and how actively it becomes live. The underlying message is subtle but powerful: leadership risk is no longer abstract, and personal stamina is part of the governance equation.

In a recent study made by Albright Partners, we found that CEO tenure in Danish life science companies have been reduced with appr. 50%, partly driven by board patience becoming a rare thing.

While CEO tenures of 10 to 15 years were common in the 1980s and 1990s, the global average is now around 7 to 8 years according to the study, with many leaving after just 5. This compressed timeframe forces CEOs to demonstrate measurable progress, quickly and continuously.

Where CEOs are most often surprised

Interestingly, CEOs are rarely surprised by what boards ultimately want. They are surprised by when, how, and how decisively boards act.

Two patterns seems to often occur:

1. First, boards believe they have been clear, CEOs often disagree.

   Signals are indirect. Language is coded. “We’d like more optionality” may actually mean “prepare divestment scenarios.” “We’re concerned about focus” may mean “kill a programme.” The consequence is assumed, not stated.

   
   

2. Second, silence is often misread.

   CEOs frequently interpret fewer questions and faster approvals as trust. Boards may intend something else entirely: observation, reservation, or a wait-and-see posture. Approval today does not equal confidence tomorrow.

When governance becomes personal

Boards typically begin with portfolio and performance concerns. But when confidence erodes, focus can shift rapidly to leadership judgment, decision style, and CEO resilience. This transition often feels abrupt to the CEO, as if the rules changed overnight. In reality, boards tend to operate in discrete jumps rather than linear progression. Months of constructive dialogue can be followed by a sudden alignment and a decisive push for change. By the time it becomes explicit, informal consensus may already be in place.

So, how can top CEOs recalibrate authority - without conflict?

The most effective CEOs do not defend authority. They redesign how it is exercised.

I have noticed some patterns that seems to consistently work:

Pre-alignment replaces permission-seeking.

Key decisions are socialised informally with influential board members before formal meetings. Surprises are eliminated. The boardroom becomes a place of confirmation, not confrontation.

Decision boundaries are made explicit.

Strong CEOs clarify which decisions they will always bring to the board, which they will inform on, and which they will simply take. Naming this explicitly often reduces interference rather than provoking it.

Transparency becomes a source of authority.

Sharing uncertainty early, articulating trade-offs clearly, and demonstrating command of worst-case scenarios builds trust. Paradoxically, greater openness tends to lead to less board intervention.

As one CEO reflected: “Boards don’t need certainty. They need confidence that uncertainty is under control.”

What CEOs wish they had done earlier

In my candid peer discussions with senior CEOs, they often converge on similar reflections.

They wish they had named the shift earlier, rather than adapting silently.They underestimated how personal governance can become.They waited too long to adjust their own operating style, from visionary to allocator, from persuader to decisor, from founder-mindset to institutional leadership.

Above all, they recognise that governance expectations rarely change loudly. They change quietly, until they don’t.

Why this conversation matters now

The board–CEO power shift is not a temporary phase. It reflects a structural change in how risk, accountability, and leadership are viewed in modern life sciences companies. CEOs who read the signals early, recalibrate proactively, and engage boards with clarity tend to retain strategic authority, even as governance tightens. Those who adapt late often experience the shift as sudden, personal, and difficult to reverse.

What today’s boards expect is rarely said out loud. But it is increasingly clear to those who know how to listen. And in a landscape defined by uncertainty, the ability to interpret, and respond to, that unspoken expectation may be one of the most critical leadership skills of all.

Click here for more info about Albright Partners