Open di­a­logue needed to make physi­cian ac­qui­si­tions work

Modern Healthcare - - Q&A -

“Health­care is in tran­si­tion. The physi­cian work­force needs to get into fur­ther tran­si­tion.”

Dr. Peter An­good is CEO of the Amer­i­can Col­lege of Physi­cian Ex­ec­u­tives, a Tampa, Fla.-based mem­ber­ship or­ga­ni­za­tion for physi­cians in lead­er­ship and man­age­ment roles. He has more than three decades of ex­pe­ri­ence as a sur­geon, pa­tient-safety ad­vo­cate, con­sul­tant and leader, in­clud­ing past roles with GE Health­care’s pa­tient-safety or­ga­ni­za­tion, the Joint Com­mis­sion and the Na­tional Qual­ity Fo­rum. Mod­ern Health­care Ed­i­to­rial Pro­grams Man­ager Mau­reen McKin­ney re­cently spoke with An­good about the ben­e­fits of hav­ing physi­cians in the C-suite, strate­gies for physi­cian in­te­gra­tion and how the ACPE and its tar­get mem­ber­ship have evolved over the years. This is an edited ex­cerpt.

Mod­ern Health­care: Are more hos­pi­tals and health sys­tems look­ing at hir­ing physi­cians for the CEO spot or even for other C-suite se­nior lead­er­ship posts and if so, why?

Dr. Peter An­good: Ab­so­lutely, there is a huge trend of physi­cians want­ing to be in em­ployed sit­u­a­tions over­all. And with some of the chang­ing care de­liv­ery and fi­nan­cial mod­els go­ing on, a lot of health­care sys­tems are look­ing to bring in physi­cians in not just clin­i­cal roles, but ad­min­is­tra­tive and lead­er­ship roles as well. This de­mand in the mar­ket­place is go­ing all the way up into the C-suite level. I think a lot of physi­cians are as­pir­ing to be in the C-suite, to even be CEOs. And a va­ri­ety of health sys­tems are look­ing to have physi­cian lead­ers at all lev­els in­clud­ing in the C-suite.

MH: What are some of the driv­ing forces be­hind that? Is it be­cause we are look­ing more at clin­i­cal qual­ity and out­comes? Why is that clin­i­cal back­ground at the C-suite more im­por­tant now or at least rec­og­nized as im­por­tant now?

An­good: A well-ed­u­cated physi­cian leader has dual strengths. One is cer­tainly un­der­stand­ing the clin­i­cal en­ter­prise. What’s best in pa­tient care and how to work with other dis­ci­plines are the is­sues that cre­ate bet­ter qual­ity, bet­ter ef­fi­ciency and more re­li­able care over­all. And then they have all those man­age­ment and lead­er­ship skills. The com­bi­na­tion is re­ally a pow­er­ful force. What the non­clin­i­cal lead­ers have al­ways strug­gled with, and they will tell you this read­ily, is they can never quite fully un­der­stand that clin­i­cal back­ground. So this com­bi­na­tion of clin­i­cal and ad­min­is­tra­tive lead­er­ship strate­gies re­ally ben­e­fits in­sti­tu­tions in many, many ways. And we are be­gin­ning to see that data come through.

MH: What are some strate­gies for physi­cian in­te­gra­tion and what are some of the things that we have learned over the past few decades about what works and what doesn’t?

An­good: We went through the early 1990s where there was a lot of ac­qui­si­tion of physi­cians and physi­cian groups. It was just sort of hop­ing for spon­ta­neous com­bus­tion to work and have it all come out nice. And we re­al­ized that doesn’t work. So in this it­er­a­tion of that process, what re­ally is im­por­tant is for the physi­cian side and the ad­min­is­tra­tive side or the health sys­tem side to get to­gether and de­cide why they want this in­te­gra­tion to oc­cur. And then they should move on a com­mon pur­pose on how best to draw on each other’s strengths and have a set of mea­sures, ex­pected out­comes and busi­ness strate­gies and then fol­low that plan with open di­a­logue. That should be an open dis­cus­sion through­out the startup pe­riod as well as in the main­te­nance pe­riod. That open di­a­logue, com­mon pur­pose and fo­cus on pa­tient-cen­tered out­comes is driv­ing a bet­ter ap­proach over­all this time.

MH: What were some of the ma­jor topics of in­ter­est at this year’s ACPE meet­ing?

An­good: Qual­ity and safety are still very top­i­cal. Ev­ery­body wants to con­tinue work­ing on that. A lot of ac­tiv­ity around value. People are try­ing to shift in terms of how do we do the vol­ume-to-value type of an ap­proach. Then there are the ar­eas around en­gage­ment and in­te­gra­tion. As an or­ga­ni­za­tion, we are do­ing more with thought

lead­er­ship. So in our thought lead­er­ship fo­rum we re­ally are bring­ing in a nice spec­trum of topic ar­eas that cover pa­tient­cen­tered out­comes, the health ser­vices re­search en­ter­prise, and mea­sure­ment. We have some pa­tient sto­ries in there as well, and we cover what it takes to be suc­cess­ful in the C-suite and to be suc­cess­ful as a CEO. Health­care is in tran­si­tion. The physi­cian work­force needs to get into fur­ther tran­si­tion and that’s what we are re­ally try­ing to por­tray.

MH: How has the Amer­i­can Col­lege of Physi­cian Ex­ec­u­tives changed over the years? Who were you tar­get­ing be­fore for your mem­ber­ship and who are you tar­get­ing now?

An­good: The or­ga­ni­za­tion is about 40 years old and his­tor­i­cally has fo­cused on that mid­ca­reer physi­cian in a hospi­tal who is go­ing into an ad­min­is­tra­tive role. What we have re­al­ized is that with the physi­cian work­force over­all, all physi­cians are lead­ers. So how do we help physi­cians as a group as­sume and move into lead­er­ship re­spon­si­bil­i­ties? As an or­ga­ni­za­tion, we are trans­form­ing from stu­dent days all the way to re­tire­ment. We have the right sets of pro­grams, prod­ucts and ser­vices to help physi­cians of all types, both in­for­mal and for­mal lead­ers, have that set of skills to em­brace lead­er­ship and im­prove health­care. Ul­ti­mately we use the physi­cian lead­er­ship plat­form. But at the end of the day, it is how we make pa­tients have bet­ter out­comes and how we drive a bet­ter physi­cian-pa­tient re­la­tion­ship in the process.

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