CEO Exchange: Physician Leadership Seen as Crucial

Acknowledging the monumental changes before them, chief executive officers attending HealthLeaders Media's second annual CEO Exchange are in agreement about one aspect of the way forward: strong leadership by physicians will be a key success factor.

Strong physician leadership is critical to aligning the goals of medical groups and hospitals and to redefining the way their organizations deliver healthcare, say chief executive officers from some of the most innovative health systems and hospitals around the country.

In roundtable discussions Thursday at HealthLeaders Media's second annual CEO Exchange, attendees discussed a range of topics and trends, including new cost reduction strategies, changing reimbursement models, and the clinical shift from a volume to a value-based business model. The three-day event at the Boca Beach Club in Boca Raton, FL, was attended by nearly 40 CEOs.

"We've declared that clinical integration requires physician leadership and clinician leadership so we've defined a dyad at the executive level consisting of a chief clinical officer and a chief operating officer," said Britt Berrett, president of Texas Health Presbyterian Hospital in Dallas, adding that his organization is moving toward a model where 65% of its executive leadership will be clinicians.

"Non-clinically-trained leaders will have a much smaller place at the table," he added.

Patrick Cawley, MD, CEO of Medical University of South Carolina Medical Center in Charleston, said his organization's Clinical Leadership Council is designed to bring together physician leaders who slowly but surely are beginning to see beyond the interest of their groups to understand the big picture of what is best for the organization as a whole.

To Serve, Coach, and Support
"We are going to make decisions about what is good for the system," Cawley said of the council. "That didn't happen right away, but over the course of a year or 18 months, we had everybody in the room thinking more about what is good for the system."

"The bigger challenge," he says, "was for the practice plan and not having that defensive, circle-the-wagons approach. It was previously always about what the practice plan could get from the hospital, so we got everyone together and thinking about the entire system. Sometimes a decision is not good for the practice plan, and sometimes it is not good for the hospital because we are thinking about what is good for the system."

Steve Newton, west region president for Baylor Scott & White in Grapevine, Texas, said his organization created a physician leadership program to develop the clinical leaders that the system needs for future success. The program has gone "exceptionally well," he said.

"It awakens these folks to the broader problems of the organization and gives them a new respect for what it means to be the captain of the ship… It's also a nice way to express a commitment to those who we think are the strongest leaders and make it so they have some real skin in the game. We look at it as succession planning," Newton said.

"The role of administrative leadership is to serve, coach, and support our physician colleagues down the path of more effective clinical integration, and to some degree to help lead a very disparate group into a more unified group through better organizational skills," he added.

A "Tsunami" of Changes
J. Thomas Jones, president and CEO of West Virginia United Health System in Fairmont, WV, believes effective physician leadership is crucial now because the industry is experiencing a "tsunami" of changes around reimbursements and clinical delivery models.

In order for healthcare provider organizations to ride out the storm, he said, physicians need to feel that they are part of the decision-making process and there has to be a willingness between physicians and administrators to work together. Otherwise, an organization may fail to impress upon its staff the degree to which the industry is changing and the need to prepare for what is ahead, he warned.

"I think the greatest problem that we all face is that people have a really hard time understanding that this is a monumental shift. It's a total change. It's not an evolution; it's going to be a revolution with what is coming down the road. And, I think that's the hardest thing to do is convince people that they are going to have to change significantly. It's not about incremental change anymore," Jones said.