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Council Connection: Physicians as Co-managers

John Commins, for HealthLeaders Media, September 28, 2011
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This article appears in the September 2011 issue of HealthLeaders magazine.

Our annual industry survey shows that healthcare leaders are somewhat mixed on the effectiveness of comanagement models for service lines, with 43% finding them effective or very effective, 44% neutral, and 13% ineffective or very ineffective. In this era of healthcare reform, do you believe this shared governance model will become more relevant or less?

 
Paul J. Hensler, FACHE
CEO, Kern Medical Center,
Bakersfield CA

More than structuring these things, relationships are important. It is very important to constructively involve physicians to the maximum they are willing to be involved, particularly by service line.

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I’ve had a lot of success involving physicians in service lines, looking at the various vendors and the various expenses in the program. They have been very constructive in finding ways to improve quality, reduce length of stay, reduce the cost of implants. When they get involved, even without incentive, I have found they become very protective of the hospital’s resources and have serious discussions
with vendors about ‘You’ve got to do better than that.’ The objective should always be to have physicians actively and constructively involved.

There is a level of trust that goes back to the relationship being more important than whatever structure you put together. If they see a common goal and if they understand—either as an employer or as the hospital they choose to use—that it needs to remain financially viable, if they see that savings go to other programs they want to see developed, you get a lot of cooperation. If they perceive that all it does is pad the bonuses of administrators, they are probably not as willing to work with you.

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