Saturday, June 2, 2007

Hospital Physician Relationships - The Hospital CEO – The IImportance of Creating Convenience for Physicians

Part 3, Convenience, Part of a Series from Sailing the Seven "Cs" of Hospital-Physician Relationships

Readers may wonder why I devote so much space to hospital-physician relationships,
Indeed, why James Hawkins and I went far as to write a book on the subject? To me the reasons are simple:

One, hospital costs represent nearly one-half of all health expenditures.

Two, hospitals and doctors compete and often duplicate services, further driving up costs.

Three; relationships between hospitals and doctors are often testy, even antagonistic.

Four, the number one reason hospital CEOs are fired is a failing out with the medical staff.

Five, many of these ill-feelings could be avoided if the hospital CEO would think of his/her preeminent role was to make physician hospital usage convenient and profitable for physicians, who are, after all, the hospital’s number one customer.

As James Hawkins, a former hospital CEO and now President of Professional Services, explained in our book, Sailing the Seven “Cs” of Hospital Physician Relationships, the second “C” that’s important for hospital CEOs to recognize for physician is creating convenience for physicians in the hospital working environment.

In his “Take Away Questions on Convenience,” Jim asks these questions.

• What resources are needed by your physicians at each point of intersection with the hospital?

• What are the things that take your doctors’ time away from the practice of medicine?

• What are the things that would make the practice of medicine more efficient?

• Since bad outcomes are one of the biggest wasters of time , how do you achieve superior results?

• How do you get timely information to the point of decision making?

• How to you develop automatic alerts to warn physicians when problems arise (dangerous lab results, drug conflicts, etc)?

In his chapter, Jim points out the physicians’ most valuable asset is time, and if the hospital CEO creates more time for the physician, at the physician’s convenience then that CEO is likely to have a pleasant working relationships with his doctors.
Here is my response to Jim’s remarks on the CEO’s responsibility and obligations for creating convenience for physicians.

In 1964, David Lambuth, an English professor at Dartmouth, wrote a memorable little book “The Golden Book on Writing.” In it he said, “If you have a nail to hit, hit it on the head.” In this chapter, Jim Hawkins hits a nail on the head, viz. saving the physician time is the greatest convenience hospitals can offer physicians.

In 1966, Peter F. Drucker, who died in December 2005, hit the head of the nail even harder in The Effective Executive. He said, “Time is a unique resource. One can’t rent, hire, buy, or otherwise obtain more time. The supply of time is totally inelastic. Time is totally irreplaceable. There’s no substitute for time. Everything requires time. It’s the one truly universal condition. All work takes place in time and uses up time. Yet most people take for granted this unique, irreplaceable, and necessary resource. Nothing else, perhaps, distinguishes effective executives as much at their tender loving care of time.”

So, you hospital CEOs, take heed. Saving your physicians time is the single best thing you can do to secure your career and make your facility more efficient and profitable. You can start by hiring a hospitalist, or a group of them. Perhaps the single best example of time saving for independent office-bound physicians in the last decade has been the hospitalist hirings by hospitals.

Drs. Lee Goldman and Robert Wachter of the University of California coined the term “hospitalist” in 1996. Now, ten years later, hospitalists’ hiring and contracting has reached gale-wind force, with 12,000 hospitalists in place and 3,000 more on the way. The reason for hospitalists’ popularity is crystal clear: in-house hospitalists are convenient for office-bound physicians, saving them time to make trips to the hospital during office hours and during their time at home.

Not only is time saved, but hospitalists increase hospital care quality, improve clinical outcomes, enhance patient satisfaction, and decrease length of stay.

In the future, my guess is that the most time-saving movement will revolve around wireless communications allowing transfer of laboratory data, patient progress notes, x-ray images, and patient histories.

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