Nobody has ever called me and asked for a CIO. They call because something is not working, or because something keeps almost not working, and they are tired of finding out about it after the fact. The title is the last thing on their mind. The function is the only thing they actually need.
I think the title confuses more business owners than it helps. CIO sounds like a corporate seat reserved for companies with a thousand employees and a budget to match. So small and mid-sized businesses skip the conversation entirely and default to whichever role is already in the building: an IT director who was promoted because they were good at fixing things, an MSP whose contract was never meant to include judgment, or nobody, because the business has grown used to making technology decisions the same way it always has, one urgent problem at a time.
Here is the distinction that actually matters, and it has nothing to do with titles. Someone keeps the lights on. Someone else decides what the lights should be pointed at. Those are different jobs, they require different instincts, and almost every business I have evaluated has the first one covered and the second one empty.
An IT director or an MSP is built to respond. They are good at it. That is the job. But direction is not a response, it is a decision made before the fire starts, about what the business is actually trying to become and what technology has to do to get it there. When that decision has no owner, it gets made by accident, by whichever vendor called last or whichever system broke most recently.
I do not care what you call the person who owns that decision. I care that someone does, and that it is not the same person who is also responsible for the help desk ticket queue, because those two jobs will always lose to each other, and the ticket queue always wins the argument in the short term.
Kevin M. Coles is a fractional CIO and the founder of Coles Technical Group. He wrote a longer breakdown of where this distinction actually lives: Do We Need a CIO, CTO, IT Director, MSP, or Something Else?
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