Transcript The Anxiety Disorders Some Practical Questions & Answers

Sandbox Harmony
Some Practical Strategies for
Encouraging Private and Employed
Physicians to Play Nicely Together
A Presentation for
the Ohio Hospital Association
97th Annual Meeting
Kendall L. Stewart, MD, MBA, DLFAPA
June 12, 2012
1Realizing
that you cannot make everyone happy is the first step.
the overall organization less unhappy is entirely possible.
3Only two strategies work—hire only happy people or create a culture where happy people rule.
2Making
Why is this important?
• Many hospital medical staffs
now include both private and
hospital-employed physicians.
• These groups do not always
play nicely together in the
sandbox.
• Diminishing the tension
between the two groups
confers a considerable
competitive advantage on the
organization that can bring this
off.
• It is not easy, but it can be
done.
• This presentation will offer
some practical strategies for
doing it.
1In
• After listening to this
presentation, you will be able
to
my life, I have aspired to be a truth-seeker and truth-speaker.
has not made me popular.
2This
– Identify three common sources
of tension between these two
physician groups,
– Explain how managing the
tension between these two
groups confers a significant
competitive advantage for the
organization that succeeds,
– Describe three practical
leadership strategies for
managing this tension, and
– Explain how to execute these
leadership strategies
successfully.
How do independent docs feel?1,2
• It depends.
• They feel unappreciated, taken-for-granted,
resentful, jealous and angry.
• And they have every right to feel that way.
• If you were in their shoes, you would feel this way
too.
• They have worked their hearts out, and these young
whippersnappers are now showing up, making more
and working less than they do.
• From their perspective, they have made the money
that hospitals are now giving to entitled,
undeserving, employed physicians.
• And what is even more annoying, these employed
physicians are taking over the leadership of the
hospital.
• And they are right.
1Sadly,
2You
some of the most successful physicians are just miserable.
can give them powerful feedback by allowing employees to rank each physician as a team player.
How do employed docs feel?
• It depends.
• They want to concentrate on the practice of
medicine instead of running a business.
• They know what they are worth in today’s market,
and they intend to get what they deserve.
• They are more interested in a balanced lifestyle;
they are not interested in an all-consuming career.
• It hurts their feelings that their independent
colleagues resent them, criticize their choices and
refuse to refer to them.
• They are puzzled that their wealthy, successful
independent colleagues are so miserable.
• Their feelings are perfectly understandable.
• If you were in their shoes, you would feel exactly
the same.
• And they are right, too.
1The
truth is, all physicians fall somewhere on the Bell Curve in every hospital.
What’s a hospital leader to do?
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1Let
Believe.
Face reality honestly and cheerfully.
Focus relentlessly on results.
Pursue patient-centered perfection.
Clarify your Rules of Engagement.
Provide all physicians with exceptional service.
Select positive leaders and give them the support
they need.
Accept everyone’s feelings.
Do what needs to be done in spite of everyone’s
feelings.
Grow thick skin.
Design and deploy new strategies.
Improve those that work; discard those that don’t.1
Never, never, ever give up.
me tell you the amazing story of the SOMC Physician Relationships Leadership Team.
Bryan, our Administrative Director of Social Work Services, and Valeria DeCamp, our Director of Nursing, came up
with the process that has produced results.
2Teresa
What is the current medical staff mix
at SOMC?1,2,3
SOMC Medical Staff
Contracted Physicians
6
32
22 1
16
35%
50
65%
SOMC Medical Care Foundation (MCF)
Emergency Physicians Medical Group (EPMG)
Kings Daughters Medical Center (KDMC)
Apogee
Our Lady of Bellefonte Hospital (OLBH)
Pike County
Contracted
1Southern
Independent
Southern Ohio Pathology
Lewis County Primary Plus
Ohio Medical Center is a community hospital in Portsmouth, Ohio.
have 126 physicians currently on staff as of May 7, 2012.
3We serve some of the most challenging communities in Ohio.
2We
What practical strategies1,2 will encourage private
and employed physicians to work together more
harmoniously?
• Deploy decision-making
processes that are inclusive,
transparent and evidencebased. (CRLT)*
• Reward physicians who
produce results. (CERP)*
• Listen relentlessly. (Physician
Forums)
• Round obsessively. (Daily
Rounding)
• Focus on patient-centered
perfection. (Individual
Physician Dashboards)
1These
2But
• Employ exceptional physicians.
(Senior Medical Directorships)
• Respond quickly to physician
concerns. (PREP Process)
• Field the best-possible
leadership team and provide
them with the training and
support they need to succeed.
(SOMC Leadership Rounds)*
• Clarify your expectations for
physician leaders.
• Encourage prompt decisionmaking and accountability.
(Leadership Teams)
are all complex processes that require a lot of time, commitment and energy to deploy successfully.
they can make a difference.
Deploy decision-making processes that are
inclusive, transparent and evidence-based.
The SOMC Clinical Resources Leadership Team (CRLT) Process
• Why should you?
– Even in a hospital, someone
is going to make a decision
now and then.
– Everyone believes the
physicians with the most
clout call the shots.
– Few understand how
important decisions are
made.
– Few believe their voices
might actually make a
difference.
– Evidence-based decision
making is fairly unusual.
1We
• How can you?
– Email an idea to every
clinician and include the
evidence for and against it.
– Invite public comment.
– Include all comments in a
presentation to an
interdisciplinary team.
– Ask participants to assess
the worthiness of the idea.
– Send the team’s assessment
to the executives for a final
decision.
– Announce the decision
promptly to everyone.1,2
recently utilized this process to decide whether to provide and launder scrubs.
nurse told me she believed she had mistakenly received the email message asking for her opinion.
2One
Reward physicians who produce results.
The SOMC Community Emergency Response Program (CERP)
• Why should you?
– Not every physician
contributes equally.
– Those who go the extra
miles should be
rewarded more than
those who contribute
only the minimum
required.
– Those physicians who
respond reliably to calls
from the ED are among
the most valuable
physicians on the staff.
1Over
• How can you?
– Set up a ED call stipend
plan that rewards
physicians preferentially
for coming in promptly.
– Reward those with the
most onerous call the
most.
– Consider a deferred
income plan that
encourages both
recruitment and
retention.
– Fund it at a level that can
be sustained.1
the past five years, we have distributed $1.8 million to both employed and independent physicians through this
innovativeapproach.
Provide the best-available leaders with the
training and support they need to succeed.
SOMC Leadership Rounds
• Why should you?
– Effective leadership is
the key to your
organizational success.1,2
– No matter how painful,
field the best-possible
leadership team
throughout the hospital.
– Leaders who can and will
produce exceptional
results are fairly rare.
– Even the most-talented
and highly-motivated
leaders need training
and support.
1Your
• How can you?
– Invite selected leaders to
meet with an
inspirational executive
weekly for one year.
– Spend 30 minutes on
questions and answers.
– Be honest and forthright.
– Spend 30 minutes
discussing a real
leadership challenge.
– The insight and
relationships you will
build—priceless.
front line managers and directors hold the keys to your hospitals success.
can only select the best, set the tone and give them the support they need.
2Executives
What results have these strategies
produced?
SOMC 2007 PRC “Excellent” Percentile Rankings1,2
90.4
Medical Records
70.5
Surgical Services
67.1
Laboratory Services
65.8
Administration
50.9
Nursing Care
48.6
Quality of Care
47.7
Pathology Services
44.2
Anesthesia Services
43.3
Emergency Services
41.5
Radiology Services
38.0
Place to Practice
0.0
1Professional
2This
Research Consultants, Inc.
is a “top box” percentile ranking.
20.0
40.0
60.0
80.0
100.0
What results have these strategies
produced?
SOMC 2008 PRC “Excellent” Percentile Rankings1
97.8
Medical Records
84.2
Laboratory Services
80.9
Administration
77.7
Pathology Services
Nursing Care
75.2
Surgical Services
74.6
Anesthesia Services
65.4
Radiology Services
65.1
60.8
Emergency Services
58.0
Quality of Care
46.8
Place to Practice
0.0
1Professional
Research Consultants, Inc.
20.0
40.0
60.0
80.0
100.0
What results have these strategies
produced?
SOMC 2009 PRC “Excellent” Percentile Rankings1
97.3
Medical Records
87.9
Nursing Care
77.7
Pathology Services
73.1
Laboratory Services
66.7
Quality of Care
64.9
Emergency Services
63.9
Administration
61.6
Anesthesia Services
55.8
Surgical Services
51.9
Radiology Services
48.7
Place to Practice
0.0
1Professional
Research Consultants, Inc.
20.0
40.0
60.0
80.0
100.0
What results have these strategies
produced?
SOMC 2010 PRC “Excellent” Percentile Rankings1
98.9
Medical Records
96.2
Nursing Care
91.2
Laboratory Services
88.1
Emergency Services
83.0
Surgical Services
81.8
Quality of Care
80.5
Pathology Services
Radiology Services
78.8
Administration
78.0
76.6
Anesthesia Services
72.2
Place to Practice
0.0
1Professional
Research Consultants, Inc.
20.0
40.0
60.0
80.0
100.0
What results have these strategies
produced?
SOMC 2011 PRC “Excellent” Percentile Rankings1
99.6
Medical Records
98.7
Laboratory Services
Nursing Care
97.5
Surgical Services
97.2
96.2
Anesthesia Services
Radiology Services
90.8
Emergency Services
90.6
Administration
88.3
Quality of Care
88.1
82.9
Place to Practice
81.8
Pathology Services
27.0
Hospitalist Services
0.0
1Professional
Research Consultants, Inc.
20.0
40.0
60.0
80.0
100.0
What results have these strategies
produced?
SOMC 2012 PRC “Excellent” Percentile Rankings1
Medical Records
100.0
Laboratory Services
99.5
Surgical Services
99.0
Patient Safety
99.0
Anesthesia Services
97.6
Nursing Care
97.1
Pathology Services
96.6
94.7
Quality of Care
Radiology Services
92.8
Emergency Services
92.7
88.7
Administration
78.7
Place to Practice
59.9
Hospitalist Services
0.0
1Professional
Research Consultants, Inc.
20.0
40.0
60.0
80.0
100.0
Where can you learn more?
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Join the discussion about practical approaches to more effective
leadership on the SOMC Leadership Blog.
Learn more about Southern Ohio Medical Center here.
Review and download this presentation and related presentations
and white papers here.
Read Results That Last: Hardwiring Behaviors That Will Take Your
Company to the Top to review some leadership strategies that
successful health care executives have embraced.
Learn more about how to confront others effectively by reading A
Portable Mentor for Organizational Leaders.
Review practical techniques for conducting crucial conversations in
Crucial Conversations: Tools for Talking When Stakes are High.
How can you contact me?1
Kendall L. Stewart, M.D.
VPMA and Chief Medical Officer
Southern Ohio Medical Center
Chairman & CEO
The SOMC Medical Care Foundation, Inc.
1805 27th Street
Waller Building
Suite B01
Portsmouth, Ohio 45662
740.356.8153
[email protected]
[email protected]
www.somc.org
www.KendallLStewartMD.com
1Speaking
and consultation fees benefit the SOMC Foundation.
Are there other questions?
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