It seems fitting for the first blog of 2014 to celebrate the future for physicians as leaders of healthcare transformation.
Interestingly, this is a case of history turning full cycle, as physicians once led healthcare and retreated during the growth of supplier-based ‘fee for service’ (FFS) to focus on the efficient performance of high margin procedures. Physicians are returning to leadership roles as the reimbursement system transforms to some form of population based reimbursement (PBR) or capitation with incentives.
This makes sense as population health requires leaders who understand the interaction between clinical, operational, and financial decisions, and can think both clinically and strategically. Experienced operational and financial leaders will not be replaced. Rather, they will move into system wide corporate positions to oversee and standardize management practices through the use of business analytics (e.g. labor, supply chain, cost accounting) and other evidence based management practices. Physicians will assume leadership roles at all levels of organizations including:
- C-Suite: CEO, COO, CMO/VPMA
- Middle management: Medical Directors, Service Line Leaders, ACO/PCMH Leaders
- Front line management: Clinical Practice Leaders/Coordinators
Every physician will need to be trained not only in the diagnosis and treatment of medical and surgical conditions but in overseeing personnel, processes, and understanding the impact that clinical decisions have on operational efficiency and financial performance. Medical schools will increasingly offer MD/MBA programs and will need to incorporate practice management concepts and skills into the regular medical curriculum. In addition, physicians will need to master new management skills regarding functioning in interdisciplinary and interdependent teams, utilizing advanced IT applications in clinical practice, working through complex systems problems, and thinking like a clinician, a manager, and a leader.
Healthcare transformation requires new skills such as building a population health infrastructure, integrating health information exchanges (HIEs) as a fundamental building block of integrated and aligned healthcare systems, performing comparative efficacy research, and redesigning operational processes to make healthcare more reliable and less costly. Physicians should welcome the opportunity to learn and master new skills and to be the architects of change, a mandate that has never been so important since the evolution of medicine from an art to a scientific art during the first half of the twentieth century. For entrepreneurs, there will be opportunities to make fortunes designing the new tools for transformation and suppliers can now transfer their capital and expertise to the focus of health and disease prevention.
This is a great time to be in healthcare and I hope that physicians see transformation as more of an opportunity than a loss but that requires the acquisition of new skills, new roles, and a new understanding of the ever expanding breadth of the modern healthcare leader as both a healer and executive.
I welcome your thoughts and wish you a happy and fulfilling new year!