Collaborative Physician-Hospital Strategies
Before reviewing Jay Warden’s new book, Creating Sustainable Physician-Hospital Strategies (Chicago: Health Administration Press), I need to disclose that the author cited the Medical Advisory Panel (MAP) at Santa Barbara Cottage Health System as a model for physician-hospital collaboration (p.61-63). I facilitated that project in 2003 and attended a MAP meeting there two weeks ago, where physicians and hospital administrators continue to come together to discuss topics of vital interest.
I am proud of what physicians and healthcare administrators have accomplished jointly at Cottage Health System, including consolidating implant vendors, which saved the hospital millions of dollars, and improving clinical outcomes. Nevertheless, I would have given this book a positive review, even if Mr. Warden had not mentioned the work that I facilitated.
The premise of this book is that healthcare leaders need to take a proactive approach to engaging physicians. Enhanced collaboration is critical to both groups’ financial success and to optimizing clinical outcomes for their communities. Mr. Warden’s book is a useful reference both for organizations who are starting down the path of financial collaboration projects and for those who have implemented them already. Checklists accompany each strategy, which will help organizations follow all the important steps. As Tom Atchison wrote in Leading Healthcare Cultures, physician-hospital relations is all about basic blocking and tackling.
Another strength of this book involves formulae to do relevant quantitative analyses. For example, organizations can derive a utilization-based approach to analyze physician supply and demand by multiplying population projections by insurance distribution by physician population ratios by physician requirements for a given community (p. 20). Organizations that want to make sure that they are doing a comprehensive physician audit will find the process Mr. Warden outlined helpful, clear, and thorough (p. 14). Critical elements include:
- Assessing demographics, utilization, demand, market share, and competition
- Understanding physician supply and demand, plus changing dynamics
- Analyzing the medical staff profile, including age, referral patterns, volume of admissions, current state of physician-hospital relations, and physician-hospital competition
I agree with Mr. Warden that hospitals must find strategies that appeal to both baby boomer- and Gen X physicians; at Cottage Santa Barbara Health System and other organizations where I have worked, I have found that the following activities appeal to both groups:
- Making physicians’ time count by streamlining processes and procedures in the setting of a multidisciplinary task force (that ceases to exist once it has accomplished its goal, so that physicians can participate in predictable time increments rather than accept the life sentence of a committee)
- Building on quick wins to heighten transparency and eventual trust
- Celebrating successes quarterly and sharing stories about collaboration to build a culture in which members feel safe reflecting and learning together
As I wrote in Collaborative Champions, physicians can identify cost savings and process improvements that build on their knowledge, wisdom, and experience and leave a lasting legacy. Through the process of discovery, they evolve from perceiving themselves as renters to acting as co-owners (Cohn KH. Collaborate for Success! Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital Executives. Chicago: Health Administration Press. 2006, p. 5).
What do you think?
- Is physician-hospital collaboration an important organizational strategy in this era of belt-tightening, regulation, and consumerism, in which our outcomes are subject to increasing public scrutiny
- Do physicians and hospital leaders agree on the why and the who, but not necessarily the how
- What stories of physician-hospital collaboration from your organization can you share in this forum
As always, I welcome your input to improve healthcare collaboration.
Kenneth H. Cohn
© 2009, all rights reserved
Posted in Physician Engagement
Comments
Comment from Maybe we should re-frame this mantra as “P/H/O 2.0″: Can we get it right this time?
In theory there is no better call than to find and build mechanisms wherein the alignment of interests and incentives can be effectively deployed – both in terms of mission and JV business plan.
Like you, I was there from the beginning and through the unsightly industry demise (i.e., the unwinding of risk based JVs) in the 90s.
We tried hard, and had like minded senior hospital leadership and “visionary” MDs in the change agent seats. Yet, we failed.
Maybe this time will be different? The strategic imperative is perhaps even weightier now than during the “risk gold rush”. We’ll see. I am skeptical; though hopeful that the industry can no longer hide behind firewalls and moats of separation; and that our “cathedrals of medicine” now must find ways to become both transparent and accountable organizations; lest the drift into a “sea of irrelevance”.
Towards this end, I see much promise from social media as “battering rams” of here-to-for unresponsive, silo driven bureaucracies. Come join the conversation:
Comment from Thanks Greg,
I appreciate your heartfelt thoughts that we will learn from our mistakes of a previous century.
Perhaps this is why we talk of the “practice of medicine.”
Subscribe via RSS
Share Your Opinions