Agenda What s changed (and why?) Changing expectations The Vision a better approach
Our Panel Mark Baker CEO, Hughston Clinic and Jack Hughston Memorial Hospital Michael Rose, M.D. Vice President Surgical Services Board of Trustees, McLeod Health Sam Agnew, M.D. Orthopaedic Trauma Surgeon President and CMO, Global Trauma Solutions
What s Changed? The business of practicing medicine The physician-hospital relationship Decline of the independent practice Declining physician career satisfaction
Physician Turnover Physician Turnover in 2012 = 6.8% (the highest since the AMGA began collecting data in 2005) Average turnover rate for physicians in their 2nd to 3rd year of practice is 12.4% Small groups suffer from 20.8% turnover among physicians in those early years 54% of physicians leave their group within the first five years Costs of Physician Turnover: Compensation salary, sign-on bonuses, income guarantees, recruiting and relocation costs Administrative separation, on-boarding, credentialing and training costs Lost revenue a PCP can generate over $1 Million annually for the hospital Intangible effects on patient satisfaction; impact on continuity of quality improvement initiatives; impact on other providers and referral patterns
Physician Employment Predictions that soon, 75% of physicians will be employed by hospitals. Merritt Hawkins http://www.merritthawkins.com/clients/blogpostdetail.aspx?postid=39406 Discussion point Do you agree?
Career Satisfaction Today, more than half of physicians would choose to become doctors again Slightly down from 54% in 2012 Huge decline from 2011 69% said they'd choose medicine again (Medscape Physician Compensation Report, 2014) In 1976, AAMC surveyed physicians who graduated medical school in 1960 Over 95% said their jobs were interesting Only 4% expressed disappointment with their careers 86% believed they were happier in their work than most other people 42% noted that they enjoyed their work more than their leisure time!
Discussion Is there still a place for the independent physician practice? Can physicians find a stable, satisfying practice setting as an employee?
New Challenges Expanding role of the physician leaders Particularly, the Department Chair Balancing autonomy with new, integrated, care delivery models, business realities, etc. Technology New payment methodologies, quality metrics, focus on patient satisfaction, etc. Clinical and research skills no longer sufficient Emotional intelligence Management Leadership Business acumen
New Expectations Leadership Innovation Clinical Excellence Collaboration Are physicians prepared? Are we preparing them? Patient Focus Productivity Adaptability Business Acumen
Chairperson Executive Assessment Average Competency Ratings ACHIEVING SUCCESS 3.0 Accountability 2.8 Focus on Patients Results Orientation 3.2 3.3 Planning & Organizing 2.7 Adaptability 2.9 SYSTEM THINKING Learning Agility Strategic Thinking Financial Acumen Judgment 3.3 3.2 3.3 3.3 3.2 RELATIONSHIP MANAGEMENT Relationship Building Team Work 2.8 2.9 3.0 Emotional Intelligence Openness to Feedback 2.5 2.4 Stress Tolerance PEOPLE LEADERSHIP Establishing Trust 3.0 3.0 3.1 Motivating and Developing Talent 3.4 Provides Direction 3.0 Holds Others Accountable 2.7 1 1.5 2 2.5 3 3.5 4 4.5 5
Discussion Starting with physician leaders how is this role changing? What has changed about hospital expectations? What are hospital leaders looking for/expecting, from physicians? What does integrated care mean to physicians what challenges does it present new demands/skills? New behavioral skills? (i.e., collaboration, communication, accountability)
A Comprehensive Approach - Goals Identify and develop physician leaders Ensure that we add physicians whose goals are aligned with the vision and culture of the system Ensure physician career success and satisfaction Build an adaptable, innovative and collaborative medical staff Increase retention and career satisfaction Improve outcomes Reduce costs Prevent disruptive behavior Improve productivity
A Comprehensive Approach Define Performance Expectations Behavioral Expectations Assess Operational fit The Interview Behavioral Assessment Develop Individual physician development plans System physician leadership development program
Discussion How can we be more deliberate in identifying and developing physician leaders? What can a hospital or system do to create an environment and culture where physicians can succeed? What can physicians do to find the right practice setting? How can we get physicians focused on specific performance goals particularly outcomes?
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