David O. Parrish, MS, MD, FAAFP
Bayfront Family Medicine Residency
 Why do we have to change?
 Current status of Healthcare Leadership
 The Physician Executive
 Leadership training (in medical education)
 Business management training (in medical education)
 How do you break down the silos (in medical
education) with respect to business and leadership
training?
 A pathway forward
 Institute of Medicine’s Crossing the Quality Chasm
Report1
 Skyrocketing health care costs2
 Management of health care resources3
Sources:
1.
http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-CareQuality-Initiative.aspx
2.
http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx
3.
http://www.aafp.org/online/en/home/practicemgt/reform.html
 Most hospital CEOs hold a degree in Masters of
Hospital or Healthcare Administration1
 Types of Experience: Strategic management,
business leadership, executive leadership1
 Physician CEOs: 235 out of 6,500 hospitals within
US2,3
Sources:
1. http://www.healthcareadministration.com/becoming-a-hospital-ceo/
2. http://www.amandagoodall.com/SS&MarticletJuly2011.pdf
3. http://well.blogs.nytimes.com/2011/07/07/should-hospitals-be-run-by-doctors/?seid=auto&smid=twnytimeswell
 Who are they?1,2,3
Board-Certified MDs/DOs
 What do they do?1,2,3
a.
b.
c.
Provide administrative direction to the health care organization’s
organized Medical Staff
Guide the Medical Staff towards the goals of the
health care organization
Provide administrative direction of the
health care organization
Sources:
1. http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=AHA/NewsStory_Article/data/HHNMAG245&d
omain=HHNMAG
2. http://net.acpe.org/Resources/Articles/Reclaiming_Physician_Power.pdf
3. http://www.aafp.org/fpm/1999/0700/p37.html
 A formal longitudinal pathway of leadership and
business training for physicians is needed
 Usually undertaken by “seasoned” practicing
physicians
 On the job +/- formal business & leadership education
 The Joint Commission
 The Accreditation Council for Graduate Medical
Education
 Liaison Committee on Medical Education
Limited requirement for leadership training for practicing physicians,
physicians-in-training, or medical students, yet they are increasingly
being evaluated on “Interpersonal and Communication Skills” and “
Professionalism”. In addition, as they progress in levels of their
educational training they are being placed into leadership roles in
their respective communities, health care organization, and health
care associations due to their expertise.
 The Joint Commission
 The Accreditation Council for
Graduate Medical Education
 Liaison Committee on Medical Education
Limited expectations for business management education for
practicing physicians, physicians-in-training, or medical
students, yet they are increasingly being evaluated on “systembased practice” and managing healthcare costs.
 Can be a physical impediment, however, more so an
organizational and/or individual mind-set that results
in the unwillingness to share or participate in a cross
system manner that will benefit the overall ecosystem
in which the organization and/or individual operates
within.
Source: Lencioni, Patrick. “Silos, Politics and Turf Wars: A Leadership Fable About Destroying the Barriers That Turn
Colleagues Into Competitors”
 Accreditational: The Joint Commission vs. ACGME vs.
LCME
 Institutional: Inpatient vs. Outpatient
 Leadership: Senior Management vs. Middle
Management
 Willingness of industry leaders to break silos
 Working across the ecosystem of health care to
develop an enhanced framework of medical education
and training as it relates to business education and
leadership training
 Measuring the change and “flexing” with the results
“Un-Siloed” Framework for the Development of the Next
Generation of Physician Executives
Start as early as possible to explain, discuss and teach not
only interactive leadership skills, but the coordinated
business expectations.