Restructuring Physician Leadership in the Era of Accountable Care

Transcription

1 Restructuring Physician Leadership in the Era of Accountable Care Session Code: TU01 Time: 8:00 a.m. 9:30 a.m. Total CE Credits: 1.5 Presented by: Todd Sagin, MD, JD

2 Restructuring Physician Leadership in the Era of Accountable Care Presented by Todd Sagin, M.D. J.D. Sagin Healthcare Consulting ( Physician Leadership: More Critical Than Ever Physician leadership is essential to the following: Delivery of safer, higher quality health care Delivery of more efficient and cost-effective health care Promotion of essential partnership between clinicians and hospitals Success in physician recruitment and retention Informed strategic planning in a time of rapid change in medical science and technology Traditional Vehicle for Provision of Physician Leadership The Organized Voluntary Medical Staff Historical Roots Ossified in Regulations and Accreditation Requirements Track record of reform efforts 1

3 Characteristics of Today s Anachronistic Medical Staff Poor track record at improving quality, safety, and the performance of physicians Amateur leadership (often inexperienced, frequent turnover, minimal training, political) Bureaucracy heavy rather than bureaucracy lite Appears irrelevant to most practicing physicians (but of great interest to problematic physicians) Often increases medical staff and organizational liability Contributes to fragmented, balkanized, siloed care A growing number of physician executive roles: Vice President of Medical Affairs (VPMA) Chief Medical Officer (CMO) Chief Quality Officer (CQO) Chief Innovation or Transformation Officer Chief Information Officer Service Line Chiefs: result of redesign of hospital operations with strong move to newly reconfigured Service Lines that organize services across the care continuum Employed departmental Physician Directors: most common examples are for units like Emergency Department or Intensive Care Unit, or for focused practices Hospitalists. 2

4 Leadership for Hospital Employed Physicians especially if organized into a multispecialty physician group practice. Such practices might have a President, a physician board, a medical director, committee chairs, and so forth. New and revitalized structures needing physician leadership: PHOs (physician-hospital organizations) CINs (clinically integrated networks) ACOs (accountable care organizations) IPAs (independent practice associations) There is a growing trend to increase physician presence on governing boards of health care organizations. There is also a growing trend for experienced physician executives to become hospital or health system CEOs. 3

5 The Growth in Physician Leadership Roles Creates Challenges Role confusion and dilution of accountability Leader overextension and burnout secondary to extended bureaucratic demands Inadequate talent pool to fill positions New political struggles Rationalizing the Physician Leadership Matrix Determine what positions are necessary, required, and/or will yield clear value Simplify and/or consolidate bureaucratic structures wherever possible Develop job descriptions with clear articulation of positions qualifications, responsibilities, and accountabilities Invest adequately in physician leadership development Determine what positions are necessary, required, and/or will yield clear value 4

6 Simplify and/or consolidate bureaucratic structures wherever possible Downsize medical staff bureaucracy: fewer committees, officers, and consider the possibility of becoming non-departmentalized Rethink departments, service lines, divisions, units In systems, consider forming a unified medical staff Develop job descriptions with clear articulation of positions qualifications, responsibilities, and accountabilities Invest adequately in physician leadership development Traditional medical staff topics (e.g. credentialing, peer review) Generic leadership skills (e.g. conflict management, change management, strategic planning) Operational leadership skills (e.g. creating a budget, project management, talent management) 5

7 Moving Your Physician Leadership Organizational Structure To One Adapted To Current Demands 6