Physician-Hospital Alignment:
Build it and they will come?
Jerome F. Levine, MD, MBA, CPE
Phillip L. Wright, FACHE
Coors Healthcare Solutions © 2014
Coors Healthcare Solutions © 2014
Objectives
• What do we mean by “alignment” vs. “integration”
• What are the Alignment Drivers
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Physician
Hospital
Physician Engagement- Built not bought
The Physician Advisory Council (PAC™)
Case Study
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“We must all hang
together, or assuredly, we
shall all hang separately”
Ben Franklin
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Physician Alignment/Integration
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Need for Hospital Physician Partnership crucial for future success
Are these just proxies for employment?
Alignment- a measure of intent
Integration- a measure of action
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Physician Alignment Drivers
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Financial security
Sharing of strategic goals
Partnership approach- economic, operational
Administrative complexity
Leadership development
Quality pursuit
Business models- employment / clinical co-management / joint ventures
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Physician Recruitment & Retention
• Recruitment is on the rise in the last several years, especially for PCP
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Aging physician workforce
Changing physician employment models
Changing physician work values
Health care reform and its impact on reimbursement
Recovering portfolios allowing retirement
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Recruitment-II
• Turnover is still high, and the MGMA’s report of 2013 noted that the
average turnover for physicians in their 2 or 3 year of practice is 12.4%;
small groups are experiencing 28.4% turnover in same group!
• The cost of losing doctors for the organization (hospital, private group)
is approximately $250k per physician not including lost revenue!
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Recruitment -III
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Previous model of new physician expectations by both parties has significantly
changed over the last 20 years:
– Work Life balance was the most pressing concern for residents/fellows and
second for practicing doctors
– Compensation was also a significant issues for over half of doctors in both
groups
– Malpractice concerns are very low in the list
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Physician Recruitment: Get Your House In Order &
Build Your Foundation
Needs
Assess /
GAP
Physician
Strategy
Physician
Alignment
Contracts
&
Compensation
Community
Need Analysis
Prioritize
goals
PAC™
Proof:
Support for
Road Map
Practice
Viability &
Due Diligence
Engage
Medical Staff
Performance
Incentives
Develop Road
Map
Transparency
= Trust
Create
Compensation
Equality
Alignment
Structure
Options
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Standardized
Contracts
Physician
Recruitment &
Retention
Physician Leadership Development
• Physician leadership is crucial at all levels to help navigate the stormy
waters of health care today
• There has been a major paradigm change
– Historically, clinicians have been judged by the quality of care and
productivity
– Today, new skill sets and tools are necessary for the successful physician
leader:
• Decision making; People Management; Communication; Strategic Planning;
Finance
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Physician Leadership Development Programs
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Research has shown that formalized leadership programs are important to
develop these skills. 1
Though MBA/MMM degrees are useful, they are not necessary at all levels of
leadership.
Developing an institution –oriented program requires several steps:
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Administrative support (CEO)
Oriented to culture ( times, days, method)
Physician involvement in curriculum development
Constant feedback
1. Rothke SE. Organizational Insight for Physician Leaders: A Critical Perspective. PEJ. March/April 2014, 40(2): 54-58.
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Jumpstart Your Physician Leadership
Development
• Build and implement your own Physician Advisory Council™ (PAC)
• Phillip Wright will discuss his success story!
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PAC™ Philosophy
• Physicians are a hospital's number #1 partner!
• This philosophy is the foundation to create a Physician-centric
customer service model
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PAC™ Design
• TRANSPARENT COMMUNICATION – Open atmosphere
• SEAT AT THE TABLE – Physician and decision makers
• DIRECT INPUT TO CEO - Input for decisions effecting physicians
and patient care
• OPEN FORUM – Early discussion with Physicians – avoiding crisis
• ALIGNMENT with Strategic Needs – Physician alignment with
Organization’s strategic needs
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A HOSPITAL CEO’S PERSPECTIVE
Phillip L. Wright, FACHE
Santa Rosa Medical Center
Milton, Florida
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Notable Quotes
• “Mr. President, if you liked your apology, you can keep it”- Dennis Miller
• “I never thought I’d miss Nixon” - Anonymous White House employee
• “NASA spent 8 years and $12 billion developing a pen that could write
in space. It had to work in zero gravity, at a range of temperatures. The
Russians use a pencil”- Anonymous
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Physician & Hospital Partnership
• How?
– Communication!!
• When?
– All the time!!
• Key Forum?
– Physician Advisory Council (PAC™)
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Hospital CEO Revelation!!
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It is not all about me - I am not in charge!
Physicians strongly desire a “seat at the table”!
Technology changes are a major disruption!
Physician clinics are unique to operate!
Visibility with physicians in THEIR clinic is critical!
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PAC™ Meeting Format
Select 12 to 15 physicians of different specialties
An equal mix of independent and employed physicians or splitters
Appoint a physician member to chair council and run the meetings
Monthly dinner meeting (good food)
CEO and Chair meet at least 24 hours prior to the PAC meeting to
“catch up”
• Open Dialogue (sitting around the dining room table)
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PAC™ Meeting Format
• No committee functions allowed (credentials, peer review, MEC, etc)
• Action Plans discussed during the meeting
• Notes taken by Administration, action plans discussed, outcomes tracked
• Discussions, actions and activities are communicated to entire medical
staff
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PAC™ = Physician Engagement
• Getting Physicians’ Participation
• Getting Physicians’ Attention
• Getting Physicians’ Commitment
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Key PAC™ Accomplishments
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10 point improvement in physician satisfaction
CPOE development and feedback
Equipment purchase guidance
New patient chart format
Parking lot lighting improved
New ER design
Relocation of orthopedic unit
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Key PAC™ Accomplishments
• Development of Cardiac unit
• OP registration process streamlined
• New services (The Women’s Place, Sleep Disorders Center, Occ Med
program)
• Advocates for recruitment of physicians (ER, Neurology, Pulmonology,
Cardiology, Urology, Primary Care
• Continuous networking due to make up of committee (Hospital based,
Specialists, PCPs, Hospitalists, CEO, CNO, CFO, etc)
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It Takes A Team
• “Gettin’ good players is easy. Gettin’ them to play together is the hard
part” – Casey Stengel
• “No member of a crew is praised for the rugged individuality of his
rowing”- Ralph Waldo Emerson
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From A Hospital CEO’s Perspective…
YES!
IF YOU BUILD IT
THEY WILL COME!!
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QUESTIONS?
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Jerome F. Levine, MD, MBA, CPE
Phillip L. Wright, FACHE
Sr. Physician Executive Advisor – Coors Healthcare
Solutions
CEO - Santa Rosa Medical Center
Jerome F. Levine, MD has over 28 years of healthcare
leadership experience, and previously held leadership
positions as EVP/Clinical Integration and Chief Medical Officer
for CaroMont Health in NC and Senior Medical Director,
Chief of the Infectious Disease Division, and Physician Liaison
of Quality and Safety at Hackensack University Medical
Center in NJ.
Dr. Levine obtained his medical degree from New York
University School of Medicine, New York, New York and MBA
from Stillman School of Business, Seton Hall University, West
Orange, New Jersey. He was honored as one of the “Top
Docs” in New York Magazine in Infectious Diseases for 1999
through 2010 and “Best Doctors in America” in 2011.
Phillip Wright was appointed Chief Executive Officer of Santa Rosa
Medical Center, Milton, Florida in August 2009. He had previously
held the position of Administrator and CEO of Mary Black
Memorial Hospital in Spartanburg, South Carolina since March
2003. A graduate of the University of West Florida, he has 32
years of experience in hospital management and operations. He
served as Chief Operating Officer of both the Carolinas Hospital
System in Florence, South Carolina, and the Columbia River Park
Hospital in McMinnville, Tennessee. He has also served as
Associate Administrator–Operations of Sebastian River Medical
Center in Sebastian, Florida, and as Administrative Director of
Support Services for Columbia Fort Walton Beach Medical Center
in Fort Walton Beach, Florida.
He is a Board Certified Fellow in the American College of
Healthcare Executives, has always been active with numerous
community organizations, and currently serves as a board member
for seven (7) local organizations.
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We Are: Recruiters, Strategists & Implementers
www.CoorsHealthcareSolutions.com
1.800.507.6917
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