CHICAGO — So your hospital is putting a bunch of physicians on the payroll? Isn't it time to find a doctor extraordinaire to lead them all and drive the push toward value-based care? Is it even in the best interest of your hospital to pull a hardworking doc away from his patients and put him in a suit and tie?
Those were some of the questions that surfaced Monday afternoon during an opening session at the American College of Healthcare Executives' 2013 Congress on Healthcare Leadership. Hospitals and health systems are employing physicians in droves, looking to gain referrals, better-coordinated care and clinical integration. It only makes sense to add more physician leaders to that mix. During a session on enhancing physician leadership, Carson Dye, author and partner at Witt/Kieffer, told attendees that there were about 154 physician CEOs at U.S. hospitals last year, up from 90 in 2000, and a small but growing number of physician COOs.
However, some in the audience worried about the ill effects of giving doctors a second full-time job and repeating some of the mistakes of managed care in the 1990s.
"Let's not do déjà vu all over again here," Frank Byrne, M.D., president of St. Mary's Hospital in Madison, Wis., said from the audience. "In the '90s, when it was fashionable to put physicians in these executive roles, we burned through almost an entire generation of physician leaders who were well-intended, but put in roles they weren't prepared to succeed in."
Speaker Jacque Sokolov, M.D., chairman and CEO of consultancy SSB Solutions, said those issues aren't unique to doctors. Any executive, physician or not, needs to know the boundaries of his or her knowledge, and find ways to augment it. Havaing doctors in the C-suite is a trend that can't be ignored. At last year's J.P. Morgan Healthcare Conference, the buzz phrase was "clinical integration," but it was overtaken this year by "physician alignment." Follow the money and it leads to physician leadership.
"Everybody is fighting for the hearts and minds of the physicians in relationship to the clinical model, which then dictates the business model, which then dictates who wins and who loses," Sokolov said. "Everyone — I mean the payers, hospitals, physician organizations — is working toward figuring out what these alignment models look like, and how physicians can take additional leadership positions that are emerging as we speak."
But how do you avoid burning out your doctors or promoting those who are doomed from the start? Dye said hospitals should shy away from some of the dusty old ways of finding clinical leaders — like simply rewarding docs for their loyalty, going on gut instinct that someone just looks like a leader, or picking "grievance docs" who make a lot of noise but are focused on personal gripes. Rather, he said, hospitals should seek out physician leaders who have a "calling" to leadership, personality traits such as authenticity and a focus on improvement, and competencies such as a compelling vision and masterful execution.
MBAs are fine and dandy, but they don't automatically turn MDs and DOs into top-notch leaders, Dye said. Rather, start by throwing doctors into the fire and let them learn through special projects, committees or other situations where there's an opportunity to get their feet wet in leadership. About 80 percent of physician leaders started out with a part-time leadership gig, Dye pointed out. And homegrown talent is the ideal way to go.
"The best thing to do is build your own. Trust me. Take this to heart," Dye said. "If physician leadership development and involvement is not one of your top five strategic priorities right now, shame on you. It should be."