In the move to value-based healthcare delivery, physician integration is key to success. As with any extensive system overhaul, the challenges that arise are both simple and complex, and aligning physicians with a hospital’s missions is no different.
For example, transitioning physicians from a more independent structure to a team approach for patient care might require training in relationship building. Determining how and when to involve physicians in leadership decisions could point toward necessary changes for current leadership assessment tools. Even physician compensation plans may require new incentives aligned with how well physicians engage and promote the value-based delivery model.
ACHE recently reached out to Christine M. Candio, RN, FACHE, president/CEO for St. Luke’s Hospital in Missouri, and past ACHE Chairman, and Alan S. Kaplan, MD, FACHE, CEO of UWHealth in Wisconsin, regarding physician integration. Both oversee two successful integrated delivery systems and are known for uniting large and diverse physician groups to achieve common goals. They will be speaking at the Master Series Session 3, “Physician Integration and Alignment,” at the upcoming ACHE Congress for Healthcare Leadership.
CANDIO: As we experience rapid changes in healthcare, it is critical to ensure effective physician alignment and engagement. You cannot have one without the other. By creating an agreed upon platform of goals and an organizational “true north”, value-based healthcare delivery can be achieved.
KAPLAN: Ultimately, it is about moving the needle on value (quality/cost). However, there are a number of steps along the way that define successful physician integration, as it relates to value-based healthcare. For instance, meeting attendance, meaningful participation in the conversation and a commitment to engage in change (and to engage their peers).
CANDIO: It is imperative for organizations to truly understand the challenges physicians are facing. One extremely important issue is physician burnout. There are a number of causes for this and an important first step is to start having an honest, open dialog with your physician colleagues. Acknowledgement is first, but then we must be action-oriented in addressing these issues. It is a journey and one that can be beneficial if all parties work together.
KAPLAN: The most important prerequisite is building trust and credibility. Absent that, nothing else moves forward. Once this is established, it is about creating a shared vision in which the physicians see themselves, and crafting a mutually agreeable path forward. Financial alignment is important but absent the other steps, it will be insufficient. It is a mistake to think that financial alignment alone will get the job done. One only has to look at the history of physician employment as evidence of this fact.
CANDIO: Two effective strategies include the creation of a Physician Leadership Institute. Targeted for formal leaders, informal leaders and “up and comers,” the institute covers a series of topics with an overarching theme of leadership growth and development. Another strategy was creating, with the help of a physician steering committee, a structure for our medical group, which includes dyad leadership, a physician advisory council and a number of topic-specific committees. Physicians must have a voice at the table to direct and grow their practices.
KAPLAN: The best strategy is shared leadership. Whether it is physician compensation plans, capital budget planning or crafting governance and management structures, entrusting physicians to make decisions within reasonable guidelines is a powerful integration method. However, it is not for the faint of heart. You must be willing to donate trust, and live by their decisions. Done well, it is powerful and enlightening.
CANDIO: I look forward to sharing my journey toward stronger physician alignment and positive integration. The topics above will be discussed.
KAPLAN: I have successfully worked with physicians in the settings of a single stand-alone suburban hospital, a large multistate health system and an academic medical center. Good management matters. But at the core are the soft skills, such as building credibility, leading change and culture development. I will share five top-of-mind soft skills that have been success factors in all settings.
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