Conflicting views exist about physician involvement in governance and leadership of health care organizations. Misconceptions may need to be overcome, including whether individuals trained to be clinical experts and autonomous decision-makers can become team players and whether physicians will be able to work with an organization’s executives and board members to achieve a larger mission and vision.

To understand how the governance of physician-led organizations is different, and similar, to that of health care systems, the AHA’s Center for Healthcare Governance and Physician Leadership Forum, with generous support from Hospira Inc., undertook a study to examine governance structure and function in a diverse set of physician organizations — entities designed to engage physicians in the leadership, governance and decision-making of the clinical care enterprise. The study is among the first to explore this work from the perspective of physicians, who shared candidly about issues and challenges and provided insights about the evolution of physician involvement in governance and leadership.

Building on the Center for Healthcare Governance’s earlier study of transformational governance, this study addresses the challenge of how health care organizations and physicians integrate to thrive in the new environment. Effectively addressing this issue goes beyond aligning incentives and requiring clinical integration; it also requires the development of a true partnership between physicians and health care organizations from the bedside to the boardroom — partnerships that engage physicians in shaping new approaches to care delivery and playing key roles in organizational governance and leadership.

Physician organizations’ strong focus on doing what’s best for patients and communities is positioning them as significant drivers of improved quality and financial performance, and architects of the new care delivery system. While their governance practices may not mirror those of hospitals and health systems, those practices are adapting to meet the needs of these unique organizations at different points in their development. The physician culture that emphasizes inquisitiveness and the importance of understanding the deeper issues that underlie clinical problems supports good governance. These organizations and their governance are evolving along multiple paths. The pace and degree of evolution may be affected by factors such as organizational ownership, market dynamics, and the need for clinical integration and care redesign.

The study recommends continued research to better understand physician organization governance and leadership as well as the development of education to support effective physician participation in governance and leadership. Additionally, the study calls for tools and resources to assist physician organization boards in strengthening their governance. The report will be broadly disseminated in order to engage the field in examining the governance roles physicians and physician organizations play. This report should enable physician organizations to be successful in achieving the Triple Aim of better health, better health care and lower costs.

As one panelist concluded, “Boards should recognize that this is a historic moment of change in health care. History is going to judge us by what we do now. It’s time for governance to rise to the challenge.” 

John R. Combes, M.D., senior vice president of the AHA and president of the Center for Healthcare Governance, leads the AHA’s Physician Leadership Forum.

News from the AHA

Umbdenstock, Lofton to receive ACHE Gold Medal awards

AHA President and CEO Rich Umbdenstock and Kevin Lofton, CEO of Catholic Health Initiatives in Englewood, Colo., will receive 2015 Gold Medal Awards from the American College of Healthcare Executives. The association’s highest honor, the award recognizes ACHE Fellows “who go beyond the confines of their own organization to continually contribute to the improvement of health care services and community health.” Umbdenstock recently announced he will retire from the AHA at the end of the year. Lofton served as chairman of the AHA in 2007. The awards will be presented March 16 during ACHE’s Congress on Healthcare Leadership in Chicago. In addition, Mario Garner, president and CEO of New Orleans East Hospital, will receive the ACHE’s Robert S. Hudgens Memorial Award for Young Healthcare Executive of the Year.

HRET to honor Shortell at July’s Leadership Summit

Stephen Shortell, a leading health policy educator and researcher, will receive the Health Research & Educational Trust’s 2015 TRUST Award at the Health Forum/AHA Leadership Summit July 23 in San Francisco. Shortell is the Blue Cross of California distinguished professor of health policy and management and professor of organizational behavior at the University of California, Berkeley, where he also directs the Center for Healthcare Organizational and Innovation Research. His research has contributed to performance improvements in quality and outcomes of care and promoted more integrated care.

Most Wired Survey now open

H&HN and the College of Healthcare Information Management Executives have launched the 2015 Most Wired Survey, which hospitals can complete through March 15. It measures information technology adoption, implementation and use in four areas: infrastructure; business and administrative management; clinical quality and safety; and clinical integration. Visit