Beyond Physician Champions: Cultivating Physician Leaders
By Rochell Pierce
With less than two years to prepare for the massive roll-out of insurance coverage to the nation’s uninsured citizens, hospitals are still struggling with the question of how they will handle the financial risk once reform becomes reality. If anything has become crystal clear since the passage of the Affordable Care Act of 2010, it is the intent of the legislation: cut health care costs and improve its quality.
It can no longer be business as usual in health care. The financial risk of caring for a defined population will be transferred to hospitals and physicians within the accountable care organization (ACO) framework. Hospitals need the engagement and cooperation of their physicians if they are to survive the transition to an ACO model of delivery. Having physician champions as figureheads will no longer be enough. It is critical that hospitals develop a new wave of physician leaders as business partners on the journey to an ACO.
A few progressive health systems around the country have already been successfully aligning the business interests of the hospital with the clinical interests of its physicians. These forward-thinking organizations have already made real strides in quality, cost efficiencies and outcomes by developing physician leaders who can be part of the operations team.
Models for developing physician leaders
Some hospitals have created a Chief Medical Officer (CMO) role within the organization. Traditionally, the purview of the CMO included oversight of utilization review, performance improvement, and medical staff affairs. CMOs served as liaisons between staff physicians and senior management. This role is quickly changing, according to the American College of Physician Executives. As hospitals morph into ACOs, the CMO will be assuming a more strategic function. The new breed of CMOs will be responsible for business and service line development, and accountable for quantifiable improvements in quality and outcomes. As part of the C-suite, they will function as CEOs of aligned group practices within the ACO framework.
Other innovative hospitals have created a new structure within the organizational chart, the hospital growth council. The growth council resides outside the traditional medical staff structure, and reports directly to the CEO. The concept is to partner a hand-picked team of physicians with top executives to work on operational issues and business development strategies. The goal is to accomplish real-time results on expanding or streamlining clinical services, finding cost efficiencies, and improving outcomes. Council members also serve as liaisons between hospital management and physicians and work directly with department managers to improve services and cost efficiencies.
Whatever the structure, it is important to find a willing candidate with the personal traits that will make a successful physician leader:
• The ability to see the “big picture” from a system perspective, rather than from a hospital-centric point of view.
• An unwavering focus on patients and quality care.
• Excellent communications skills, able to articulate a clear and compelling shared vision and to consider opposing viewpoints.
• The willingness to get out of the office and engage with others.
• Excellent multi-tasking and conflict resolution skills.
• A commitment to learning – and functioning within –
the business of health care.
What are some of those educational needs for doctors aspiring to become physician leaders? First, they need a better understanding of hospital financials and the key measurements that impact the bottom line. They should have a working knowledge of payer reimbursement trends and projections. Physicians should also have a good grasp of the competitive marketplace and delivery trends, such as projections on utilization and gaps in services. And they need to understand the “big picture” scope of services, including other physicians’ service lines.
In the age of ACOs, health systems will need more than physician champions. They will need partners who can galvanize other doctors around the imperatives of cutting costs and improving quality. Developing physician leaders now will strategically position health systems for the realities of 2014.