Remember back when hospital executives and physicians had what might charitably be described as an adversarial relationship? One side regarded the other as profligate prima donnas; the other peered across the great clinical-management divide and saw penny-pinching buttinskies.

As Uncle Skid would say: Not no more.

These days, management and medical staff realize that working together is critical to their mutual survival. New care delivery models encourage it and new payment models demand it. Clinical integration, physician engagement, organizational alignment — whatever you choose to call it — is at the top of every hospital’s to-do list.

“It’s a unique time in that we recognize now, more than ever, that we can’t accomplish our goals of managing cost, quality and outcomes without physicians at the table making decisions with us,” says Steven Linn, M.D., chief transformation officer and chief medical officer of Inspira Health Network, Vineland, N.J.

For their part, Linn says, physicians know they can’t go it alone. They need the resources the health system can provide, including access to quality and cost data. “It’s the perfect storm,” he says, "bringing the relevance of physician engagement to the forefront right now.”

Linn was on a panel of hospital leaders convened this summer by Hospitals & Health Networks and VHA Inc. to discuss strategies for engaging physicians. The event was part of our ongoing Fiscal Fitness series.

Actively bringing physicians into the strategic planning process is key. “In the past, we would develop initiatives to assist our physicians,” says Dominic Moffa, executive vice president of AtlantiCare health system. “Now we’re saying, ‘Let’s come together to cocreate the future for the populations we serve. How do we become cocreators of the hospital, administrative structure, governance and the physician community? How can we cocreate a new model so that we can serve physicians and the populations they’re responsible for in a high-quality, cost-effective way?”

Panelists described a range of tactics. Newly developed clinical integration committees led by physicians themselves are tasked with developing tools to drive out variation. Formal leadership training is offered on a regular basis. Physicians are serving on subcommittees of the boards of trustees and as full-fledged board members. And more and more health systems are bringing physicians into C-suite positions.

“As we move forward,” Moffa says, “there will be less distinction between physician leadership and professional management. The line between the two is starting to blur.”

In the not-too-distant future, asserts Jeffrey DiLisi, senior vice president and CMO of Virginia Hospital Center, "Some of the most successful organizations will probably be led by physicians who can professionally manage. We need to teach them how to do that. It’s an important skill and the best physician leaders will have that skill set.”

Hospitals and physicians still wary of each other better get over it. "Neither party will be around 20 years from now if we go it alone," Linn warns.

You can read the panel's entire Executive Dialogue beginning on Page 51.

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