Physician leadership is a big topic at this year's AMGA annual conference, which kicked off with an all-day pre-conference workshop on "How to Groom the Next Generation of Physician Leaders."
The first session featured J. Gregory Stovall, MD, senior vice president of medical affairs at Trinity Mother Frances Hospitals and Clinics in Texas, who described physician leadership development using a gardening/farming analogy. He outlined four basic steps:
Creating fertile soil. Creating a culture of leadership in an organization is essential to growing physician leadership opportunities, Stovall said. Trinity began by rewriting bylaws to require the president of the organization to be a physician and boards to reserve seats for physicians. It also prioritized financial support, creating compensation models based on annual performance reviews and bonuses for all vice president level positions and higher. "I can't stress enough the importance of the annual reviews," Stovall said.
Planting good seeds. In this case, seeds are physician leaders, and "planting" refers to the recruitment process. Stovall partnered with the other presenter on the session, David Cornett, regional vice president for Cejka Search, to identify leadership potential, in addition to clinical skills, when recruiting new doctors. They used behavioral interviewing skills to dig into candidates' previous leadership experiences.
Watering and fertilizing. Recruiting physicians with leadership potential is not enough. That potential has to be nurtured and developed, and Trinity does this through a variety of on-site training programs. There are more examples later in the day of facilities working to educate physicians about the business aspects of healthcare.
Harvesting. By harvesting, Stovall means optimizing the return on investment. Solid physician leaders often increase revenue through new or expanded service lines or enhanced reputation and recognition, but they can also significantly reduce costs by spearheading quality improvement initiatives or reducing turnover (for both physicians and support employees).
Harvesting is obviously the stage that organizational leaders are most excited about, but to optimize a physician leader's ROI, it's important to start with the organization's culture, and cultivate leadership throughout the growth process, Stovall said.
In separating the roles of health czar and health secretary, President Obama is adding to an already large stable of experts who will help him in his effort to overhaul the healthcare system. But it was not immediately clear who would dominate, or who would corral members of the ever-growing team, with their varying viewpoints. While all the players agree that the goal is providing affordable health insurance to all, they have expressed different ideas about how to get there.
Despite being bailed out three times by the legislature since 2000, the University of Connecticut Health Center is now running a deficit of nearly $17 million for the current fiscal year. The Health Center is also forecasting deficits of $21 million in the fiscal year that starts July 1 and $30 million in 2010-11 if Gov. M. Jodi Rell's budget proposal is approved, according to UConn officials.
Even as Pennsylvania struggles with a growing budget deficit, senators questioned why Gov. Ed Rendell's administration is proposing to cut at least $20 million to hospitals that disproportionately serve Medicaid patients as well as the uninsured poor. At a budget hearing of the Senate Appropriations Committee, both Democratic and Republican senators expressed concerns about Gov. Rendell's proposal to slash payments to those hospitals by roughly 15% in his proposed $29 billion budget for 2009-10.
An increasing number of physicians are asking for the patient's share of that day's medical fees, including any deductible set by the insurer, at the time of the visit. At one Washington, DC, doctor's office, a video screen in the waiting area tells patients that if they don't have their insurance card, the practice would be happy to "reschedule your appointment." That practice also asks that the co-pay be provided before the patient sees the doctor and calls patients in arrears to a window in full view, and earshot, of other waiting patients.
Doctors claim they are seeing more and more cases of MRSA in children. According to the Centers for Disease Control and Prevention, an estimated 95,000 people in the United States developed serious MRSA infections in 2005, the latest data available. While the CDC cannot say how many children were infected, the agency reported the greatest increase in hospital visits were among those under 18 during an eight-year period ending in 2005. Children are especially vulnerable because of their underdeveloped immune systems, experts say.