ROUNDS Preview: Driving Clinical Improvement Through Physician Leadership

This article appears in the December 2012 issue of HealthLeaders magazine.

Editor's note: This piece is excerpted from a full case study that is available as part of the upcoming January 8, 2013, Rounds Event, Building Clinical Integration: Scott & White's Physician-Led Delivery Model. For more information, visit www.healthleadersmedia.com/rounds.

Working together, physician leaders and administrative leaders can achieve critical clinical and organizational goals.

As with many of its clinic-model peers across the county, Scott & White Healthcare began as a partnership of necessity between doctors Arthur C. Scott Sr. and Raleigh R. White Jr. to serve the growing area around Temple, Texas, as new railroads raced across the state in the late 1800s. But to label Scott & White simply as a clinic-model integrated delivery system is too limiting to a success built on understanding the needs of the healthcare system and aligning its physicians to meet it.

Scott & White was a closed-model HMO until recent years when it opened up slightly to a fee-for-service network. The clinic and hospital were not merged until a single CEO, Alfred Knight, MD, was appointed in 2000. The medical group remains a faculty-model practice affiliated with the Texas A&M Health Science Center College of Medicine. Now, with the focus in healthcare reimbursement on a shaky path back toward risk-bearing contracts, Scott & White is positioning its physician organization to deliver value, service, and coordination to roughly 240,000 health plan members and other aligned system patients. What is consistent throughout the organization is physician leadership and accountability toward quality and performance goals. But that consistency was not easily earned, says Scott & White President and CEO Robert Pryor, MD.

"Well, the one thing that's kind of easy to articulate but difficult to put in practice is the physician leadership," Pryor says. "In other healthcare systems where I worked, the hospital's healthcare leadership was primarily by nurses. At Scott & White, we actually have physicians who are responsible to a budget, responsible to creativity, responsible to our Lean management philosophy, and who actually huddle daily with the people who work with them."