A clinical background can also make one a savvier negotiator with payers, says Frank J. Cracolici, RN, MHA, president and CEO since April 2016 of St. Vincent Medical Center, part of Verity Health System in Los Angeles.
“The reimbursement structure in California is particularly complex and heavily managed care. And when you’re talking about risk, you’re talking about how best to move patients through the system in a high-quality, cost-effective manner,” he says. “Having that clinical background—knowing what types of treatments and procedures, and understanding membership demographics, comorbid conditions, and the overall complexity of patient care needs is essential in strategic negotiations. Gaining a better understanding of what one can expect during the course of an acute hospitalization really prepares a leader for having a more thorough discussion not only with physicians but with payers.”
For these reasons and more, Hundorfean, a nonclinician running a healthcare system, sits firmly in the camp favorable to clinician leaders. “If you get clinicians involved in decision-making, you’ll make better decisions, you’ll invest money in the right places, you’ll make better use of your clinicians’ time, and it will be a better experience for your patients,” she says.
Select for success
Nonetheless, neither administrative ambition nor clinical excellence alone make for a successful clinician leader.
“Sometimes, unfortunately, it’s a bit of trial and error,” says Hundorfean. “But you have to be very good at selecting leaders who you think have the personalities, as well as the qualifications, to be able to lead efforts that are beyond their basic skill set.” Tasks such as making budget cuts, for example, can be difficult for physicians unaccustomed to making those type of decisions, she says.
AHN’s newly created leadership development program can offer individuals a chance to experience the realities of administrative roles in advance. “Our program seeks to provide clinicians with the opportunity to be an executive apprentice of sorts to make sure the role matches their expectations and capabilities.”
There is an art and science to selecting for success. “Every doctor is intelligent,” says Lynn Massingale, MD, cofounder and chairman of Knoxville-based TeamHealth, which offers outsourced clinical care across a variety of specialties to approximately 3,400 acute and postacute facilities and physician groups nationwide. “At the same time, they don’t all have the right personalities or interpersonal skills for leadership.”
At TeamHealth, clinicians identified for leadership positions undergo evaluations—such as DiSC profiling, a personality and behavior assessment tool—that help illuminate traits of one’s personality style.
“We actually use some tools for testing prospective physician and business leaders, but we look for high emotional IQ, empathy, ability to build consensus, etc., as starting points,” says Massingale. “Then we take those prospective physician leaders and help them understand what their strengths and weaknesses are, show them the areas they need to work on to be better leaders, and over a number of courses, augment their skills in conflict resolution and communication, to fill in the gaps.”
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.