Re: February H&HN’s Executive Dialogue, an expert panel discussion titled “Leadership Development: Building the Workforce of the Future”

Another key takeaway: Hospitals and health systems will need to place a higher priority on their organizational culture, what it is and what it needs to be, and how candidates will be assessed based on cultural fit.


Culture is mentioned 23 times in this article and these lead-ers understand the importance of creating a culture that will support and facilitate organizational values and mission. Culture will eat strategy for breakfast!

— Karen Mathews

True physician engagement

Re: “Improving Physician-Hospital Engagement” by Todd Kislak in H&HN Daily, Feb. 10

Understanding and supporting physician needs, concerns and priorities is the first step in improving physician engagement and behaviors. Increasing complexity, more accountability, and changing incentives and models of care have certainly taken their toll by increasing physician discontent, stress and burnout. Before true engagement can occur, physicians need to understand what changes are occurring and why, and how it will impact them. Then they need assistance in helping them to adjust better to the changing environment.

Organizations need to recognize that physicians are so entrenched in the dynamics of day-to-day care that they either lack insight, time or willingness to take a step back and evaluate what’s happening.

Asking for support is another matter. We can’t leave it up to the physicians to take action on their own. The organizations they work for need to take a proactive stance in providing support through education; open, two-way discussions; and services that support their operational and emotional needs.

— Alan Rosentein, M.D.

Unleash advanced practice nurses

Re: “Nurses Create Models of Care for an Aging America” by Bill Santamour in H&HN Daily, Feb. 17

The physician-dominated regulations that bar advanced practice nurses from practicing at the top of their licenses have to be addressed by the broader health care community, and consumers as well. The Federal Trade Commission published a report last year recommending that these regulated collaborative agreements be lifted and no further restrictions be added. APNs are the solution to many of the health care delivery issues that are embedded in the Affordable Care Act. As millions are being added to the roster of covered lives and there is a 20-year shortage of primary care phsycians, APNs are standing ready to deliver primary care, psychiatric/mental health care and many other program-specific services. But the struggle to be legislatively independent of physicians has to happen in every state. We need to unleash this vital workforce as a public service.

As APNs are moving to get doctorates in nursing practice, these curricula address what is needed: diagnosis, treatment, referral to MDs for specialist care, patient education and coordination of care. ... Nurse-led, collaborative practice health homes are the future.

— Nancy M. Valentine, R.N., PhD, MPH

Patients want physician time

Re: “10 Ways Your Primary Care Practice Can Save Billions for Health Care” by Marty Stempniak in H&HN Daily, Dec. 17, 2014

As a DPC physician just starting out … I think a benefit of direct primary care is that it allows physicians to spend more time with patients, and the patients value that; they measure the quality of their health care by the time they spend with the physician. So many of the solutions I have seen proposed by health care administrators focus on building a team for primary care. The problem is the team has to be managed by the physician, and the time he is spending managing the team is not spent with the patients. That is not to say that a physician should necessarily do everything in his practice, but we should be wary of solutions that rely on physicians’ handing patients off to team members when what the patients want is the physician himself.

— DrBadFish


An InBox article in the January issue incorrectly stated the annual cost of stroke care in the United States. The actual cost is $38 billion.