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Collaborative Moderation

I salute Ron Yee, CMO at United Health Centers of the San Joaquin Valley, who introduced me when I presented at the annual meeting of The National Association of Community Health Centers (NACHC) on Field-Tested Strategies in Physician Recruitment, Contracting, and Retention. 

Community health centers provide care to approximately 20,000,000 patients, which is expected to double in the next five years because of recent healthcare reform legislation, hence the interest in physician recruiting and retention.  

After each of my two presentations, I fielded questions, concerns, and comments, to which I replied based on my work in 40 states during the past twelve years.  Dr. Yee provided valuable content from the perspective of a center CMO with 17 years experience, as the following examples show:  

• An administrator from Detroit asked how to recruit to areas that are traditionally hard to recruit to.  I mentioned building on strengths, such as the cost of living and affordability of housing; I also encouraged her to ask new hires to talk up their work environment with physicians from their residency programs before the residents made decisions on where they wanted to work.  Dr. Yee added that they had equally good results recruiting physicians and dentists from the other end of the career continuum who were nearing retirement and wanted to work part-time.
•  A physician asked about questions of fairness balancing the needs of new hires with those of established veterans.  I encouraged her to keep the process transparent, so that everyone knew the rules for base pay and incentives for productivity, quality, and citizenship.  Dr. Yee said that based on experience, centers needed to look at compensation benchmarks every 1-2 years and bring everyone up as benchmarks rise.
• Another administrator asked about succession for the CMO position at her center as the present CMO neared retirement, concerned that no in-house candidate had the interest or background to step up to the position.  I countered that until physicians had an opportunity to be mentored in a project that builds on their interests, it was difficult to know who might have the interest and ability to step into the role.  In addition to sending physicians to conferences that expand their administrative knowledge and asking them to summarize and apply what they learned when they returned, I suggested sponsoring a physician clinical priority setting task force, in which clinicians from a variety of backgrounds listened to presentations from all the major sections and departments on their strengths, challenges, opportunities, and threats that they face and then recommended the top 3-4 activities that would address the issues that arose.  Dr. Yee succinctly answered, “Help physicians find their niche.”

What Dr. Yee said resonated with me because helping physicians find their niche is something that has been my passion for the last twelve years.  As we age, the marginal value of doing one more procedure or seeing one more patient starts to decline.  Being involved in a project that matters to a physician can help them leave a lasting legacy that makes them proud and benefits the community.  In Collaborative Champions, I mentioned: 

• In the first chapter of my upcoming book, “Getting It Done: Lifelines from the Field,” I salute an ICU director who collaborated with middle-level laboratory, nursing, and pharmacy administrators to cut the mortality rate from sepsis in half by improving the timeliness of processes during the critical hour when a patient is suspected of having a bloodstream infection
• In Chapter 7 of Better Communication for Better Care, I discussed a cardiology catheterization lab director who used healthy competition to cut costs and improve outcomes 
• In Chapter 2 of Collaborate for Success!,  a previously skeptical nephrologist, who had avoided participation in hospital affairs for over two decades, became such a convert after serving on a medical advisory panel, that he became the first physician ever asked to serve on the hospital’s strategic planning committee; he also convinced his patients to contribute to the new hospital’s capital campaign.

Thanks to Dr. Yee and physician champions like him who work at community health centers throughout the US.  

As always, I welcome your input to improve healthcare collaboration.  Please comment on what physician champions are doing where you work to improve care for your community. 

Kenneth H. Cohn  

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