Dr. Cohn’s passion has been helping physicians, hospital executives, nurses, and board members to work more interdependently. The joy of seeing skeptical physicians act like owners to improve care for their communities has been exciting and fulfilling, with sustainable improvement in clinical and financial outcomes.
For example, at Santa Barbara Cottage Health System, following a clinical priority setting project that Dr. Cohn facilitated, an orthopedic surgeon persuaded his colleagues to consolidate implant vendors from eight to two, saving the hospital $4.2 million over the next three years. CEO Ron Werft remarked, “Dr. Cohn was instrumental in a successful medical staff planning process at Cottage Hospital in 2003. He gained the trust of the physicians very early on and helped them establish important clinical priorities for our hospital.
Dr. Cohn helps create a safe environment for learning and reflection despite a rapidly changing marketplace that makes conflict inevitable. For example, he facilitated a project that allowed a hospital system to partner with its physicians in a way that made a long-term building project successful, as CEO Tom Gagen described below:
We were in a situation where we needed to consolidate two campuses for both economic and quality improvement. Ken showed us a way to start an interface of physicians and hospital executives, alerting physicians to the complexity of running a hospital and helping hospital executives feel more comfortable engaging practicing physicians. In addition, even though I have been in Hospital Administration for many years, I now have a better understanding of the complexities physicians face and how to communicate with them with their concerns more in mind.
For the first time in our history, we now have a road map written by a consensus of our top clinicians; we also have identified several previously unidentified physician leaders who can help us go forward. Ken facilitated both processes.
Ken accomplished what he did in an atmosphere of integrity and sensitivity, increasing trust and transparency from the physician and hospital administrator perspectives.
Dr. Robert Schott, Medical Advisory Panel co-chair and later VPMA, wrote: at Sutter, [Dr. Cohn] successfully brokered a peace by coaxing the disaffected parties into a substantive discussion by helping to define the issues which fueled the mistrust. It was one of the most interesting and helpful processes in which I have had the opportunity to participate!
Dr. Cohn helps hospital executives become more comfortable with clinical issues, allowing them to ask patient-related questions without fear of ignorance or embarrassment, for example:
- CEOs with strategy, culture, and performance issues relating to physicians, physician engagement, conflict resolution, and physician leadership development
- COOs with operational issues that affect physicians’ use of time, ways to reduce the cost of expensive supplies (such as prostheses), and financial collaboration strategies, including clinical integration models
- CFOs with engaging physicians to cut costs while maintaining quality
- Physician executives (VPMAs, CMOs) to understand the interface of business and medicine and to develop effective communication and conflict resolution strategies with practicing physicians and other C-suite executives, which allows them to be an integral part of the process of change
- Nurse executives to understand and depersonalize physician attitudes and to vent confidentially about male-female behavior differences that affect the workplace environment
- CIOs to become more comfortable with clinical issues as seen by practicing physicians, such as ways to engage physicians to adopt and use electronic health records
A hospital executive confided, “If I have a problem with my board, I can resolve it. But if I have a problem with doctors and they tell other influential doctors, I better dust off my resume.”
(Cohn KH. A Practicing Surgeon Dissects Issues in Physician Hospital Relations. Journal of Healthcare Management. 2009; 54(1):5-10).
Ken has proven himself to be very able to work with disaffected doctors. He’s a practicing surgeon himself which gives him credibility with the docs, and he can get angry, non-communicative physicians to open up.- Dr. Robert Reid, Director of Medical Affairs, Cottage Hospital
Dr. Cohn capitalizes on the fact that physicians enjoy learning from fellow physicians, as he helps physicians learn techniques of active listening, win-win negotiation, and conflict resolution that physicians generally are not taught in medical school, residency, or fellowship. As Dr. Michael Ivy noted:
Ken earned the respect of both groups for his understanding of business processes and his outstanding ability to communicate. In part, his success is due to his years as a clinician, which gives him a knowledgeable, genuine physician perspective.
The service he provided went far beyond the scope of the project. For example, he mentored a section chief and obtained for him profit and loss figures that the section chief had never seen before. He was instrumental in helping that section chief craft a bold, far reaching presentation. He consistently reached out to the other presenters and provided them with invaluable assistance.
Ken’s understanding of the problems facing hospitals and physicians in these challenging times is outstanding.
As this Chief of Staff noted, physicians feel safe learning from fellow physicians:
I am currently chief of staff at a 350-bed hospital that has been bleeding red ink for two years. In ten months, we lost 20% of our hospital governing board, fired our CEO and CMO and hired a new CEO. I realized in my first year that I needed an experienced guide to help me with basic survival and to use my experiences for personal and professional growth.
Ken has been a tremendously valuable resource. He has made himself available when crises loom. His calm objectivity and talent for reframing issues have helped me find my way forward, and, at times, I am amazed at how much better equipped I feel to deal with my daily duties as a medical staff officer.
Debra Morley, M.D.
“Co-mentoring” means that each party brings knowledge, strength, and wisdom to the process:
Over the course of 2 years I have evolved from a rock-tossing member of the medical staff to the VPMA at my hospital, where I work with administration and my fellow physicians, striving to promote co-mentoring relationships.
Co-mentoring implies that the partners in the relationship are on equal footing, which greatly improves communication, particularly among physicians who are sensitive to hierarchy.
Ken Cohn facilitated a dialogue between the medical staff and administration in 2005, which was transformative, both for the institution and for me personally.
I recognized that the hospital and medical staff shared an important objective: providing the highest quality patient care, and that we could best fulfill that goal by finding ways to work together. We have identified a new generation of physician leaders that has begun to change the practice environment and our workplace culture.
Ken brought us along with a formidable toolkit that allowed us to define and begin working through critical issues from a starting point where basic civility was not necessarily the norm.
Robert J. Schott, MD, MPH, FACC
Ken Cohn is an inspiring teacher and speaker. He combines self-deprecating humor with infectious enthusiasm for his subject. More importantly, he has penetrating insight into the complicated dynamics between doctors and administrators, as well as between doctors and doctors. His skills were instrumental in accomplishing a significant turnaround in the dysfunctional relationship between our medical staff and hospital leadership.
Chuck Rinker, MD, FACS, Bozeman Deaconess Hospital
Thank you for your mentoring assistance. I had not received training in administrative and leadership aspects of healthcare and needed the background that you provided me to perform effectively in my new role as Medical Director.
As a result of our work together, I have evolved from the command-and-control model that I learned in medical school and residency to a style based on active listening and a more democratic-coaching model. I am much more skilled at explaining the rationale and benefits to others than during residency, when I used a do-it-faster-myself style.
I used to avoid conflict-laden situations, especially those that involved confrontation. Now, I am more comfortable initiating the process of discovery and being part of the process of change in my organization.
Thanks for the energy, insight, and integrity that you brought to the process. I look forward to working with you in the future.
Brian Hansen, DO, Executive Medical Director, ABCM Corporation
The impact of culture on quality, safety, innovation and our ability to navigate a healthcare organization through turbulent times cannot be understated. In the future, I see even greater need for this kind of work, and I consider you a pioneer, I am happy that our paths crossed and hope that they do again.
Anne Meisner, CEO Cancer Treatment Centers of America SE, after Dr. Cohn taught physician leadership development modules on communication, relationships, and team-building
You are the “can do” physician trainer and consultant.
Steven Babitsky, President, SEAK