Friday, April 8, 2016

Physician State of Mind and Physician Leadership : Get On with It
Today’s physicians, in their quiet moments, usually admit that their profession and they are in deep trouble.  Physicians too often work too hard for too little; they spend too little time on what they consider to be the “practice” of medicine; they believe they are disrespected by hospitals and insurers; primary care docs envy specialists; specialists despise hospitals; and worst, they just flat do not like their day jobs to the point that there is rampant burnout, anger, and depression. Not quite Marcus Welby.
Jim Purcell, Financing Physicians:  A Modest Proposal,  The Health Care Blog

Lessons for Leadership
Certain things are obvious:
It takes a group of physicians to make a difference  in competitive health care markets. One-on-One patient-physician relationships  no longer cut it.   Physicians have to unite with each other to do what needs to be done.  Physician groups have to get bigger to compete,  so bigger they must get. Bigger groups need physician leaders, so leaders they must get. Leaders don’t grow on trees,   groups must develop their own leaders.
Sutter Group Leadership Development
Those are the lessons learned by the Sutter m Medical Group in Northern California.  In January 2001, the group expanded from 353 to 534 almost overnight due to a merger .
Two physicians leaders said of the transition.
Dr. Lee Anne Wong and her colleague, Sue Gotelli,MD,  directors of physician leadership development for Sutter Health, the system to which SMG belongs, shared their story at the conference believing many organizations across the country would relate.
“I think a lot of people have had the same experience with rapid growth of medical groups and mergers and acquisitions,” Gotelli told me by phone after the conference. “What people realize is that the bigger the group, the more structure you need to keep it running well, both from a management perspective and a leadership perspective.”

The two soon articulate 5 keys to physician leadership development.

1)    Physician leadership roles have multiplied, thanks in part to the increasing emphasis of  value and population heath management.

2)    Succession planning to a larger group had to begin with physicians just out of training, who are more amenable to becoming leaders than older physicians.

3)    Leaders were not born, they have  to be made.  Said Gotelli, “They stumble a little bit until they realize there is actually science behind leadership development, that there are known things people can do and practice to get good at it.  And when they really understand this is not something you’re just born with, that you can work on it, I find physicians to be great students who can put leadership concepts into application very quickly.”
4)     Best Practices Aren’t Just for Medicine - Physician leaders need not just skills development, but  support and resources. When clinicians become medical directors or service line leaders, they need precise job descriptions, information about how to perform tasks, names of people available to help, and more, according to Wong.
5)     5. Money Matters, to a Point -Although Wong and Gotelli’s presentation didn’t address compensation for leadership work specifically, audience members, many of whom were physicians, were curious about whether Sutter’s physician leaders got paid for their administrative work.
Most  physician leaders at SMG maintain a full clinical practice and receive additional compensation relative to a 0.2 to 0.4 full-time equivalent, roles,” she says.
What truly motivates almost all of the physician leaders she’s worked with, however, is the ability to impact greater numbers of patients by being a leader than through one-on-one care alone.“Most successful physician leaders I’ve seen have had some sort of aha moment,” Gotelli says. “It’s a bit of a leap of faith. You can’t really explain it to someone until they experience it.”


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