The widening rift between hospitals and physicians exposes patients to medical risks, inconsistent service quality, economically motivated care, and disparities in access to treatment. Physician executives are well positioned to lead the reversal of this trend and prepare the medical staff and hospital for the collaboration necessary for their mutual survival.
The senior management team at a West-coast community hospital was having difficulty maintaining high levels of physician satisfaction, keeping an open-door policy, and providing the facilities, technology, and staff necessary for success. The board of directors established a physician relations committee to mediate disputes, but a conflict over payment for emergency room call and rumors regarding development of a physician-owned specialty hospital demonstrated the physicians’ disconnection from the hospital and the need for a new interactive mechanism, which Dr. Reid, the physician executive, and Dr. Cohn co-facilitated.
The timing was right for the formation of a new physicians’ advisory group in which engaged doctors would reflect on what they felt the community needed, what the hospital should provide, and what would improve the environment for practicing physicians:
- The CEO selected two physicians to co-chair the medical advisory panel (MAP). Doctors eligible for selection were those who had earned the respect of their clinical colleagues and with whom the CEO could relate and build transparency and trust.
- The co-chairs selected the remaining panel members, who had to be active physicians well respected by their colleagues and willing to make time in their schedules to evaluate clinical priorities.
- Abrasiveness was not a disqualifying trait. Few physicians refused to participate despite learning that the group would meet for two hours every week for eight months.
- MAP members were compensated for the time they spent attending meetings, which emphasized the value the organization placed on their activities.
The MAP’s accomplishments include:
- Years of frustration attempting to get the orthopedic surgeons to agree on implant cost reduction to leverage the vendors on price ended when one of their most respected colleagues, a member of the panel, saw the reasoning, did the research, and convinced his colleagues to consolidate vendors from eight to two, which generated annual savings of $1.6 million each year for three consecutive years.
- Unhappy surgeons working in what felt like an inefficient operating room were mollified when, at the MAP’s recommendation, consultants were brought in to identify and assist in implementing best practices and metrics to monitor performance. Significant improvements resulted from installation of an operating room dashboard featuring more than 20 measures, which are reported monthly to the surgical departments of the medical staff. The operating room staff received the 2009 GE Healthcare Centricity Perioperative Customer Innovation Award.
- Neuroscience advances have transformed the care of patients with stroke and intracerebral hemorrhage in the community, evidenced by increased utilization of clot dissolving agents, Joint Commission certification as a stroke center, and establishment of a neuro-endovascular service, which enjoys a referral base from multiple counties and has put the hospital in a new market position.
Collaboration is the key to survival in today’s rapidly changing healthcare environment. Hospital-centric programs fall short because of the differing ways in which physicians and hospital leaders view the world. Use of a medical advisory panel can engage physicians and turn their energy into a positive force that improves the practice environment and thereby benefits physicians, hospital leaders, and most importantly, the community. A physician executive is in a unique position to facilitate such a forum.
As always, I welcome your input to improve healthcare collaboration and get it done.
Kenneth H. Cohn
© 2011, all rights reserved
Disclosure: I have not received any compensation for writing this content.