SAN DIEGO—What is a physician leader?
That's a question that David Nash, M.D., dean of the new School of Population Health at Thomas Jefferson University gets asked quite often, especially now as hospitals and physicians are racing to find better was of integrating and aligning. It may be a question many of you are asking. Or, you may be wondering, "Where are my physician leaders?"
Either way, the issue of tapping physicians as both clinical and strategic leaders is fast becoming of paramount importance. That is partially why the American Hospital Association just launched the Physician Leadership Forum, which is aimed at helping docs and hospitals figure out ways to navigate the changing health care landscape and improve care. Nash spoke at the initiative's inaugural event following the Health Forum-AHA Leadership Summit in San Diego.
Nash, who has written extensively about physician leadership issues since the publication of his first book "Future Practice Alternatives in Medicine" in 1986, laid out the challenge ahead for the nearly 100 hospital leaders—many of whom are clinicians—who stuck around for the meeting.
The push toward population health, outcomes-based reimbursement and greater accountability necessitate that hospitals groom physician leaders. "How good of a job do we do in training physician leaders? Do we pick out potential candidates and groom them?" Nash asked. He noted that hospitals have gotten pretty good at doing this with nurses. That type of model needs to carry over to the docs, he said.
Building on a theme from Atul Gawande's Summit keynote address, Nash reiterated that we are now moving into an era where physicians can't do it alone. Team-based care must become the norm, he said. In fact, that was the focus of the Physician Leadership Forum meeting.
Clinical teams from AtlanticCare, Brigham and Women's Hospital, and Marquette General Health System detailed how they've essentially blown up their practice models and rebuilt them into team-based care. At AtlanticCare, for instance, the hospital has built what it calls the Special Care Center to target chronically ill patients. The team-based approach is somewhat modeled on ICU care and creates a medical home. On the team sits the usual suspects: health coach, physician, nurse practitioner, social worker, pharmacist and specialists. But it also includes the patient, the patient's family, the insurer, IT, community partners and others. The SCC opened its doors in 2007 and has since enrolled 1,800 patients. The results thus far: a dramatic reduction in disparities of care for racial and ethnic minorities, a 4-6% drop in 30-day readmissions, a 97-99% fill rate on prescriptions, 94% of patients saying they felt their doctor spent enough time with them, and more.
"If hospitals are going to prepare themselves for survival, they really need to take a team approach to primary care management," said Katherine Schneider, M.D., senior vice president at the New Jersey-based health system.
Moving forward, the Physician Leadership Forum will continue to look for ways to share best practices and innovative programming. Its next scheduled event is a webinar on health IT.