Practices to Discard in 2013

The inspiration for practices to discard in 2013 comes from an excellent article by Bob Herman, entitled, “10 Ideas That Hospital and Health System CEOs Need to Ditch.” in Becker’s Hospital Review.

I was pleased that so many of them involved physician-hospital relations, as italicized below:

1. Old: Micromanage your employees. New: Empower your employees.

2. Old: Management by walking around. New: Management by watching and listening.

3. Old: Knowing everything and dictating the work. New: Knowing your leadership and trusting them.

4. Old: No mistakes are allowed. New: We learn from our mistakes.

5. Old: Physicians are the customers. New: Physicians are our partners. Physicians have always been the cornerstone care provider in the health delivery system, and they are becoming even more important as hospitals and health systems partner with physicians through employment agreements, accountable care organizations, bundled payments and other physician-centric reform efforts.

With that in mind, it’s essential for CEOs to not make the mistakes of the past. Namely, don’t treat physicians as if they are merely consumers that need to be sold something. Glenn Fosdick, president and CEO of The Nebraska Medical Center in Omaha, says hospital leaders need to foster an environment of collaboration in both recruitment efforts as well as ACO-type initiatives because hospitals need physician support to have a chance of being successful.

“When it comes to our staff, it’s not just one physician. Our high-performing staff is physicians, their supporting staff and the environment that is needed to attract these types of high-quality physicians,” Mr. Fosdick says. “We’ve been fortunate that we have some incredibly talented people here, and in my years of experience, good physicians attract other good physicians.”

6. Old: Having clinical competency is enough. New: Clinical competency is expected, and collaboration is required. In order to be a CEO of a hospital or health system, it is generally expected that person knows the basics of clinically important routines.

7. Old: Buy a lot of new technology. New: Invest in people and culture. While new CT scanners and electronic health records are vital components of any 2000s-era hospital and health system, they alone do not keep patients well. It is the physicians, nurses, staff — the people — that create a culture of comfort and stability.

8. Old: Demand change. New: Nurture change. CEOs who desire to become more “reasonable” in their leadership styles must define the fine line between demanding change and nurturing change. Demands can often come across as commandeering and overbearing, but CEOs still must prod employees toward a new norm.

Paul Levy, former CEO of Boston-based Beth Israel Deaconess Medical Center, recommends hospital leaders lose the old idea of martial law leadership and instead nurture new outcomes through Lean principles. Lean techniques, which are centered on preserving a group’s value-based motives, aim to reduce the waste, and leaders can drive Lean principles by training the staff to identify immediately when something goes wrong. This process allows CEOs to set a framework for the change desired, but physicians, nurses and other employees are the actual agents of change.

9. Old: Gloss over drivers of chronic diseases. New: Promote holistic health and well-being programs. Chronic diseases are the leading drivers of higher healthcare costs, and many chronic diseases can be avoided through improved lifestyle decisions.

10. Old: Formal leadership. New: Informal leadership. To reiterate George Bernard Shaw, no CEO should want to be the “unreasonable” person that stands in the way of healthcare reform.

“Everyone is scrambling to do things a different way,” Mr. Spiegelman says. “While there is a big focus on patient-centric care, I believe we’re missing the point if we don’t realize that before we improve patient care, we have to change the way we lead in our organizations. It requires looking inside first, and all of these ideas relate to methods of leadership if we’re going to survive over time.”

In Ten Rules for Strategic Innovators: From Idea to Execution, my Tuck Professor Vijay Govindarajan wrote that “Forget, Borrow, and Learn,” should be every leader’s guide for leading in times of uncertainty.  Healthcare leaders who want to master strategic innovation need to forget old rules as they borrow core capabilities from successful innovation efforts and systematically learn new skills.

The rationale for innovation is not only organizational preservation but also engagement, as Chris Ham noted in his post, Why Engagement Matters:

  • If integrated care is to become a reality, leaders will need to work across organisations and services, using influence as much as authority
  • Collaboration and co-operation, and working through consensus, have never been more crucial
  • Stronger engagement between staff, clinicians and patients is crucial to improving patient outcomes

As always, I welcome your input to improve healthcare collaboration where you work. Please send me your comments and suggestions for improvement.

Kenneth H. Cohn
© 2012, all rights reserved


I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.

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