Finding a Common Table: Physicians and Executives Coming Together as Partners

More and more frequently, physicians are stepping into leadership roles in hospitals and health systems. In fact, many observers predict health system CEOs in the future will be predominantly physicians.

The Tale of Three Tables.

At MEDI Leadership we’ve identified three distinct leadership tables. Each presents its own challenges for physicians who find themselves in new roles such as chief medical officer, vice president of medical affairs or chief clinical informatics officer. Challenges are also prevalent for those who find themselves working in an all-new clinically integrated network (CIN).

Each table requires unique table manners.

This new reality means physicians need to bring new skills to the table. To further complicate things, the role of the physician leader and his/her relationship to their hospital executive partners is very different at each table. This different set of expectations means unique “table manners,” or rules, are required for each.

The First Table:

Physician Leadership in a Hospital

Historically, administrative executives managed hospitals, and the medical staff was granted privileges to practice there, sometimes creating a contentious relationship. Today, due to the shift to value-based payment, physician leaders often serve as “translators” between clinical and non-clinical staff working together to improve quality and patient safety, the patient experience and overall patient health as well as to generate better financial margins. It works well for the hospital clinicians, but the autonomy of the independent physician staff members can hinder efforts to drive change.

The Second Table:

Physician Leadership in a Medical Staff

As hospitals become more accountable for the outcomes of the care of patients, management usually turns to the medical staff officers for guidance. But a medical staff is designed to ensure staff is trained and certified and patient safety practices are enforced, not to change the clinical and business practices of its members. Yet in the new world of healthcare, running a business that assumes the risk for the management of a population’s health inside and outside the hospital is necessary. Originally, the medical staff arrangement wasn't designed to run the business and it helps to have administrative executives at the table.

The Third Table:

Physician Leadership in an Integrated Business

Both physicians and executives are managing risk together. Here, the goal is to manage the business performance of physicians such as keeping referrals in-network, assuring patient satisfaction, and following clinical protocols based upon best evidence-based practices. It falls under population health management and requires new business competencies that combine both the institutional resources of the health system and the collaborative leadership capacity of physicians including:

• Automated care management: Electronic Health Record, linked from inpatient to outpatient services, with best evidence-based protocols
• Reduction of inpatient readmissions
• Increasing patient engagement
• Managing cost and utilization of resources across the continuum of care
• Managing clinical quality metrics by provider
• Stratification of patients and targeted interventions

Succeeding at the Common Table

Collaboration, political acumen, motivating others and adaptability are the relationship skills that are critical to the success of physician leaders. The best way for physicians to learn these skills is through an experiential process where executive and physician leaders come together as equal partners around The Third Table, or Common Table, with the right table manners.

Take the next step:

Talk to MEDI Leadership