Bridging the Physician-Management Chasm
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"We've discovered that if you really want physicians to have a major say in treatment, let's not have them reinvent what they want to do with each patient, but let's thoughtfully discuss how to manage a
condition. Take pneumonia, for example. We try to use literature to create care paths and invited a representative from each hospital to do that."
He says much of the resistance to clinical protocols comes from physicians feeling they are being forced to follow protocols for which there isn't enough data to prove they are more beneficial to the patient. But Stadnyk says such resistance stems from physicians feeling that their expertise has not been taken into account in developing the protocols. That's why representatives from hospitals he manages develop the protocols on their own.
"If you cannot find the right way, you will get to the best way faster by having everyone do it the same way," he says.
Stadnyk sees himself as a change agent, and one of his key wins in managing physicians in the system is convincing them to do things "one way" if evidence is not available.
"That has been the largest part of linking finances to clinical," he says, making the contention that reducing variation in practice leads to fewer mistakes and thus lower overall healthcare costs. He also claims the reduced variation produces better patient satisfaction, naturally, but that it also leads to higher employee satisfaction and retention because they don't have to cater to each physician's particular needs for similar patient conditions.
While Banner also works with independent physicians in many instances, Stadnyk is transforming the employed physician staff by describing the "Banner way" of practicing medicine to all applicants for employed physician status in the belief that employment leads to strong alignment. Banner works hard to find that alignment of purpose. The system recently interviewed 85 anesthesiologists in order to hire 10. Stadnyk also is a strong believer in the dyad management style, in which a physician leader is paired with a business expert from administration to run a service line. But a prerequisite is accepting the way the health system has decided to practice medicine, and that is according to evidence of best practices.
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