As the healthcare system evolves, the demand for physicians with strong leadership and business skills continues to grow. The problem for many healthcare organizations is that they don't have systems in place to train and develop such leaders.
Is business knowledge and an understanding of finances important to the medical profession?
According to the second installment of a recent three-part survey jointly conducted by the American Association of Physician Leadership and the Navigant Center for Healthcare Research and Policy Analysis, 90% percent of physician leaders believe the answer is “yes”.
The problem, however, is that only 47% say their organizations have formal physician leadership training in this area.
Why the disconnect?
“The disconnect is part of our historical evolution,” says Peter Angood, president and CEO of the association.
The Smarter Strategy
According to Angood, healthcare systems have historically been organized primarily to cater to physicians and the medical staff. And as healthcare has evolved, the default approach is that a lot of what healthcare leaders have been focusing on is the business aspect of maintaining their revenue stream and their bottom line. But as healthcare has evolved, the focus is shifting from catering to physicians to engaging them in management and strong leadership roles.
“The problem,” Angood says, “is not every health system has figured it out yet, which is concerning.”
Paul Keckley, PhD, managing director of Navigant, says that from a historical standpoint, the healthcare system has been structured around three domains: clinical, operational, and financial. The change that’s beginning to occur is the convergence of all three of those domains.
“You cannot operate in the future without a vista to all three,” Keckley says. “People in the operational and financial domains have always had a hands-off of [the clinical domain]. But now we’re codependent. And unless the clinical domain is in the C suite and it’s playing a prominent role in decisions not only about clinical practice but about the operation of that practice and the financing of that practice, we’re going to continue seeing fragmentation.”
Physicians Want In
Angood says that physicians today, those in leadership roles as well as those in regular practice, are quick to understand that they must develop a more refined knowledge, separate from their clinical environment, in order to function effectively within those administrative and financial deliberations.
“They’re all saying, ‘We need more skill sets,’” Angood says. “There’s a drive on the part of the physician workforce to consume this type of information. And we’re seeing that all the way back to the students and resident trainees.”
What does a comprehensive, formal physician leadership training program look like? Keckley says there are two frameworks that may become the prototype for the future. The first is that healthcare organizations will be led not by one physician leader, but by a team of physician leaders in prominent roles. The second is where organizations identify the prospective physician leaders of the future and have an ad hoc curriculum to develop them.
“Those institutions and systems that have their own independent program oftentimes fall into the same cluster of organizations that we identify as high-performing health systems already,” he explains. “And they’re high-performing for a variety of reasons. But they have already identified the importance of physician leadership and education, providing them experiences, so that they can then rise into the different roles pivotal in making an organization better.”
Assessing the Priorities
The third installment of the survey found physician leaders citing better quality care and lower costs as priorities for healthcare going forward. More than 90% of survey respondents agreed on the importance of reducing unnecessary care, thus increasing the value of healthcare services.
“There is an important focus on not only driving quality better, but also how do we drive efficiencies and cost control in there as well,” Angood says. “And those two components, as we all know, are parts of the value equation. Value is quality over cost.”
Recognizing the criticality of having well-trained physicians in leadership positions, the AAPL has begun putting together a series of initiatives which, at their core, are focused on redefining the relationship between physician leaders and financial leaders.
“And we recognize that both sides of that equation, when working effectively together and understanding each other’s world, more strongly influence the outcomes of health system delivery performance overall,” Angood says.
Keckley echoes those thoughts, noting that the survey results demonstrate the timely need to educate and empower physicians as leaders within healthcare organizations.
“I think that the fellowship in medicine, the day-to-day practitioners may not accept that the cheese has moved; and they may not believe necessarily that physicians need to have much to do about cost, but the leaders know it,” Keckley says. “And the good thing is they want the tools and the organization’s support to make it happen.”