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Keeping Tabs on the Docs

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As minimally invasive procedures enter the surgical playing field with greater frequency, specialists on both sides are starting to feel the pinch. Doctors performing traditional “open” surgery want to share in the less-invasive windfall, while interventional radiologists and others who work with the latest in surgical tech want to expand their patient base (see “Turf Wars,” HealthLeaders, March 2006). When it comes to specialty overlap, Ken Mack, president of DMI Transitions, a Brecksville, Ohio, consulting firm, says many hospital executives are unaware that there’s a problem until things blow up. Such an oversight may cost the CEO his job. “To the docs, that administrator, who often lacks a medical degree, made a decision that affected their ability to practice medicine,” says Mack, who makes these recommendations for ensuring the proper vigilance:

Post sentries

The busy schedule of a CEO is not conducive to keeping one ear to the ground, so charge other senior leaders with monitoring the climate and alerting you to potential trouble spots among the physicians.

Eavesdrop on the docs

Keep tabs on discussions at the medical staff level and in section meetings. You’ll know who’s upset and what his or her concerns are long before the information would normally reach the C-suite.

Let your vendor be your guide

The technology you choose can have a big impact on the way your physicians practice medicine. Use equipment vendors as a barometer to detect potential patterns of conflict and get ahead of the curve. “Those sales reps are out in the field and they’re hearing things,” says Mack.

Get to know your payors

Question managed care contacts about changes in specialty reimbursement policies. If interventional radiologists are getting paid to do the work of vascular surgeons, you can anticipate that the physicians will come calling. “When the payor opens that door, it’ll happen,” Mack says.

—Kara Olsen