Physician-Hospital Alignment: Build it and they will come? · Coors Healthcare Solutions ©2014...

Physician-Hospital Alignment:Build it and they will come?

Coors Healthcare Solutions © 2014

Jerome F. Levine, MD, MBA, CPE

Phillip L. Wright, FACHE


Objectives

• What do we mean by “alignment” vs. “integration”

• What are the Alignment Drivers

– Physician

– Hospital

– Physician Engagement- Built not bought

– The Physician Advisory Council (PAC™)

– Case Study


“We must all hang together, or assuredly, we shall all hang separately”

Ben Franklin


Physician Alignment/Integration

• Need for Hospital Physician Partnership crucial for future success

• Are these just proxies for employment?

• Alignment- a measure of intent

• Integration- a measure of action


Physician Alignment Drivers

• Financial security

• Sharing of strategic goals

• Partnership approach- economic, operational

• Administrative complexity

• Leadership development

• Quality pursuit

• Business models- employment / clinical co-management / joint ventures


Physician Recruitment & Retention

• Recruitment is on the rise in the last several years, especially for PCP

– Aging physician workforce

– Changing physician employment models

– Changing physician work values

– Health care reform and its impact on reimbursement

– Recovering portfolios allowing retirement


Recruitment-II

• Turnover is still high, and the MGMA’s report of 2013 noted that the average turnover for physicians in their 2 or 3 year of practice is 12.4%; small groups are experiencing 28.4% turnover in same group!

• The cost of losing doctors for the organization (hospital, private group) is approximately $250k per physician not including lost revenue!


Recruitment -III• Previous model of new physician expectations by both parties has significantly

changed over the last 20 years:

– Work Life balance was the most pressing concern for residents/fellows and second for practicing doctors

– Compensation was also a significant issues for over half of doctors in both groups

– Malpractice concerns are very low in the list


Physician Recruitment: Get Your House In Order & Build Your Foundation


Community Need Analysis

Proof: Support for Road Map

Needs Assess / GAP

Prioritize goals

Practice Viability & Due

Diligence

Develop Road Map

Physician Strategy

PAC™

Engage Medical Staff

Transparency = Trust

Alignment Structure Options

Physician Alignmen

tStandardized Contracts

Performance Incentives

Create Compensation

Equality

Contracts &

Compen-sation

Physician Recruitment & Retention

Physician Leadership Development

• Physician leadership is crucial at all levels to help navigate the stormy waters of health care today

• There has been a major paradigm change

– Historically, clinicians have been judged by the quality of care and productivity

– Today, new skill sets and tools are necessary for the successful physician leader:

• Decision making; People Management; Communication; Strategic Planning; Finance


Physician Leadership Development Programs • Research has shown that formalized leadership programs are important to

develop these skills. 1

• Though MBA/MMM degrees are useful, they are not necessary at all levels of leadership.

• Developing an institution –oriented program requires several steps:

– Administrative support (CEO)

– Oriented to culture ( times, days, method)

– Physician involvement in curriculum development

– Constant feedback1. Rothke SE. Organizational Insight for Physician Leaders: A Critical Perspective. PEJ. March/April 2014, 40(2): 54-58.


Jumpstart Your Physician Leadership Development

• Build and implement your own Physician Advisory Council™ (PAC)

• Phillip Wright will discuss his success story!


PAC™ Philosophy

• Physicians are a hospital's number #1 partner!

• This philosophy is the foundation to create a Physician-centriccustomer service model

Coors Healthcare Solutions © 2012 14

PAC™ Design

• TRANSPARENT COMMUNICATION – Open atmosphere

• SEAT AT THE TABLE – Physician and decision makers

• DIRECT INPUT TO CEO - Input for decisions effecting physicians and patient care

• OPEN FORUM – Early discussion with Physicians – avoiding crisis

• ALIGNMENT with Strategic Needs – Physician alignment with Organization’s strategic needs

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A HOSPITAL CEO’S PERSPECTIVE

Phillip L. Wright, FACHESanta Rosa Medical Center

Milton, Florida


Notable Quotes

• “Mr. President, if you liked your apology, you can keep it”- Dennis Miller

• “I never thought I’d miss Nixon” - Anonymous White House employee

• “NASA spent 8 years and $12 billion developing a pen that could write in space. It had to work in zero gravity, at a range of temperatures. The Russians use a pencil”- Anonymous


Physician & Hospital Partnership

• How?

– Communication!!

• When?

– All the time!!

• Key Forum?

– Physician Advisory Council (PAC™)


Hospital CEO Revelation!!

• It is not all about me - I am not in charge!

• Physicians strongly desire a “seat at the table”!

• Technology changes are a major disruption!

• Physician clinics are unique to operate!

• Visibility with physicians in THEIR clinic is critical!


PAC™ Meeting Format

• Select 12 to 15 physicians of different specialties

• An equal mix of independent and employed physicians or splitters

• Appoint a physician member to chair council and run the meetings

• Monthly dinner meeting (good food)

• CEO and Chair meet at least 24 hours prior to the PAC meeting to“catch up”

• Open Dialogue (sitting around the dining room table)


PAC™ Meeting Format

• No committee functions allowed (credentials, peer review, MEC, etc)

• Action Plans discussed during the meeting

• Notes taken by Administration, action plans discussed, outcomes tracked

• Discussions, actions and activities are communicated to entire medical staff


PAC™ = Physician Engagement

22Coors Healthcare Solutions © 2013

Key PAC™ Accomplishments

• 10 point improvement in physician satisfaction

• CPOE development and feedback

• Equipment purchase guidance

• New patient chart format

• Parking lot lighting improved

• New ER design

• Relocation of orthopedic unit


Key PAC™ Accomplishments

• Development of Cardiac unit

• OP registration process streamlined

• New services (The Women’s Place, Sleep Disorders Center, Occ Med program)

• Advocates for recruitment of physicians (ER, Neurology, Pulmonology, Cardiology, Urology, Primary Care

• Continuous networking due to make up of committee (Hospital based, Specialists, PCPs, Hospitalists, CEO, CNO, CFO, etc)


It Takes A Team

• “Gettin’ good players is easy. Gettin’ them to play together is the hard part” – Casey Stengel

• “No member of a crew is praised for the rugged individuality of his rowing”- Ralph Waldo Emerson


YES!

IF YOU BUILD IT

THEY WILL COME!!

From A Hospital CEO’s Perspective…


QUESTIONS?


Jerome F. Levine, MD, MBA, CPE

Sr. Physician Executive Advisor – Coors Healthcare Solutions

Jerome F. Levine, MD has over 28 years of healthcare leadership experience, and previously held leadership positions as EVP/Clinical Integration and Chief Medical Officer for CaroMont Health in NC and Senior Medical Director, Chief of the Infectious Disease Division, and Physician Liaison of Quality and Safety at Hackensack University Medical Center in NJ.

Dr. Levine obtained his medical degree from New York University School of Medicine, New York, New York and MBA from Stillman School of Business, Seton Hall University, West Orange, New Jersey. He was honored as one of the “Top Docs” in New York Magazine in Infectious Diseases for 1999 through 2010 and “Best Doctors in America” in 2011.

Phillip L. Wright, FACHE

CEO - Santa Rosa Medical Center

Phillip Wright was appointed Chief Executive Officer of Santa Rosa

Medical Center, Milton, Florida in August 2009. He had previously held the position of Administrator and CEO of Mary Black Memorial Hospital in Spartanburg, South Carolina since March 2003. A graduate of the University of West Florida, he has 32 years of experience in hospital management and operations. He served as Chief Operating Officer of both the Carolinas HospitalSystem in Florence, South Carolina, and the Columbia River Park Hospital in McMinnville, Tennessee. He has also served as

Associate Administrator–Operations of Sebastian River Medical Center in Sebastian, Florida, and as Administrative Director of Support Services for Columbia Fort Walton Beach Medical Center in Fort Walton Beach, Florida.

He is a Board Certified Fellow in the American College of

Healthcare Executives, has always been active with numerous community organizations, and currently serves as a board member for seven (7) local organizations.


We Are: Recruiters, Strategists & Implementers

www.CoorsHealthcareSolutions.com1.800.507.6917


Physician-Hospital Alignment: Build it and they will come? · Coors Healthcare Solutions ©2014...

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