As rising numbers of physicians seek to be hired by hospitals, chief medical officers must understand how to lead and manage clinicians who are accustomed to acting with great autonomy.
The times, they are a changin', and physicians need new skills, knowledge and strategies to fill today's leadership jobs, especially if they strive to fill chief medical officer slots in their organizations.
That's the belief of the American College of Physician Executives, the largest association for physician leaders in the U.S. ACPE has partnered with The Joint Commission to launch what it's calling a first-of-its kind CMO Academy.
Physician chiefs must learn to coordinate and guide integration between private practice doctors, skilled nursing homes, accountable care organizations, affiliated health services like home health agencies or population health interventions, relationships that barely or loosely existed just a few years ago, says Peter Angood, MD, ACPE president and CEO.
That may mean tapping colleagues on the shoulder to ask why they are ordering a particular test or procedure, or why they aren't ordering one, or why their patients have high rates of readmission, he acknowledges. CMOs-in-training also learn tactful strategies to drive quality and utilization rates toward acceptable levels.
As rising numbers of physicians seek to be hired by hospitals, and hospitals to employ them, CMOs must also understand their new role as an employer and manager of clinicians who used to be peers and who are accustomed to acting with great autonomy.
"There continue to be forces in healthcare, working toward better efficiency, safety, quality, and shifting to value, and with that there's an inherent expectation from non-clinical administrators that somehow or other the physician workforce will be able to tackle those things and make them work better, " Angood says.
"Unfortunately, the measurement and public reporting strategies aren't as mature as they could be, so it's important to have a well-respected clinical leader to champion these types of initiatives. They need to get the culture shift, the buy-in, and thus the improvements within the medical staff. "
For example, a well-trained CMO should be skilled in guiding physicians in private clinical practice from thinking about their patients one-on-one, as they see them in clinical settings, and instead in the broader context of population health.
"Take diabetes, " Angood says. "When you have well-organized CMOs, they are overseeing the implementation and utilization of practice guidelines around diabetes care. And then you see improvements in patient care, efficiencies improve and finances improve for most of our organizations. "
The CMO Academy is sponsored jointly with TJC because the Commission also "recognizes the importance of having physician engagement in order to create organizational change, " Angood says. "This is not just about getting better with accreditation reviews; this is actually about creating change in healthcare, and transforming how healthcare is delivered with the role of the CMO being there. "
Course titles include "From Autonomy to Teamwork, " "Quality and Safety for Physician Leaders, " and "Essentials of Health Law. "
Participants will also start projects, for example, how to design a diabetes management program that includes foot complications, a frequent occurrence in this population. And they will learn how improvement should be measured and reported.
One family practice physician planning to attend is Ellen Piernot, MD, who in January became the CMO of Sunset Community Health Center, a group of four federally qualified health clinics in Yuma, AZ with 75,000 patient encounters a year.
Sunset also works with a Medicaid shared savings program, which raises the stakes for her new role.
"We're very good at fixing one-on-one problems with patients, " Piernot says. "But when you progress into a CMO role, you need to step back and look at what's in the best interest of populations that you're serving, and then find solutions. "
One example is the difficulty in managing meetings with independent physicians, she says.
"Just getting a group of physicians in a room together— a lot of physicians do not know how to run a meeting like that, " Piernot says. "That is one of the things ASPE and the CMO Academy will help people do. How do you learn to lead a team? How do you learn to get to an effective solution with people who are very used to being the decision makers when they were in the room with a patient. "