Physician Leadership in the Age of Population Health, Part 1

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What physicians and organizations need to know in the era of population health and physician leadership

The healthcare industry is changing more rapidly than it has since its inception. Provisions in the Affordable Care Act of 2010 ensure that millions of Americans will now have health insurance and the healthcare paradigm will shift from volume to value. With population health as the leading construct, healthcare organizations are struggling to rapidly transform a system centered around individual physicians, detached practices and RVUs to a cooperative ecosystem centered around the patient, long-term health outcomes, and a team-based approach to quality, multi-disciplinary care. This transformation requires many physicians who are both willing and able to embrace the physician leadership model. From the primary care physicians who will be required to lead the team responsible for patient care to chief medical officers and chief operating officers required to better manage the organization, the development of physician leaders will determine the success of population health management across the U.S.

Today, approximately 5% of hospital leaders are physicians. This is expected to increase rapidly because the administrative decisions made under population health management will directly affect patient care. In theory, a business-savvy clinician would provide a myriad of competitive advantages. After all, physicians were trained to put patient care first; if that emphasis can be married with business acumen, everyone wins. This train of thought is why, in a survey conducted by The Advisory Board Company, 60% of hospitals reported a plan to hire more physician leaders over the next 5 years.

Experts agree. According to a whitepaper published by the American Association for Physician Leadership (AAPL), “Matured physician leadership will be essential for healthcare to continue moving toward higher quality, consistent safety, streamlined efficiency, and becoming value-based.” But, how will mature physician leaders be developed when business, management, communication and leadership skills are not taught in medical school and residency? And, how will healthcare organizations that have become accustomed to hiring corporate titans for administrators learn how to hire – and become comfortable with – physician leaders?

In this new era of collaboration, physicians and healthcare organizations must be committed to evolution in order to succeed.

How Can Physicians Prepare for Leadership Roles?

The CanMEDS Physician Competency Framework identifies and describes several roles for physicians: medical expert, communicator, collaborator, manager, health advocate, scholar and professional. Universities are responding to this description and the need to train physician leaders. According to a September 2014 article in The Atlantic titled “The Rise of the MD/MBA Degree,” the number of MD/MBA programs has doubled in the past decade; now, more than half of the nation’s 133 accredited medical schools allow students to simultaneously pursue an MBA and an MD. In addition, Masters programs in healthcare administration, public health, healthcare informatics, medical management and population health have sprouted across the country. Dr. Stephen Klasko, president of Thomas Jefferson University, home of the first Masters and PhD in Population Health programs says, “Jobs will be needed in healthcare 10 years from now that aren’t even imagined yet and a good many will be in population health.”

This job creation has already started. Executive-level titles like chief medical officer, chief of clinical integration, chief integration officer, and chief transformation officer indicate that clinical leadership is necessary to improve the health of populations – and healthcare organizations are hiring. Physicians and medical students are bearing witness to this change and know that to be competitive, leadership and business skills must become as routine as taking a patient’s history and physical. Take Scott Cowan, MD, a cardiothoracic surgeon at Thomas Jefferson University Hospital, for example. Mid-career, he knew that he wanted to pursue an administrative position. “I enrolled in the Masters in Quality and Safety Program in the College of Population Health at Thomas Jefferson University and I’m thoroughly enjoying it,” he said. “I see what is coming.quality, safety, reimbursement and the overall health of populations will be forever linked. And I will be well-prepared to lead teams in this dynamic and evolving environment.”

In addition to obtaining a business, leadership or management degree, below are the top recommendations for aspiring physician leaders:

  • Join a Team: Physicians are trained to be deficit thinkers – to autonomously identify a problem and come up with solutions. Joining a committee or a group that emphasizes collaborative brainstorming and participatory decision making and leverages the skills and experiences of multiple people is a good place to start to shift this mindset. The sooner “me-centered” thinking can authentically become “we-centered” thinking, the better.
  • Commit to Lifelong Learning: Dedicate yourself to understanding the healthcare revolution – from the legislation to reimbursement to public policy. Leaders must be educated about the change they are tasked with managing.
  • Seek Out Leadership Opportunities Within Your Organization: Sit on a strategic planning or technology committee and make administrators aware that you are interested in being a part of the changes that are happening.
  • Seek Out Leadership Opportunities Within Your Industry/Spheres of Influence: Leadership opportunities exist within professional societies and associations, and even within your personal life. Run for a leadership position in your professional organization or a seat on the board of a school or charity about which you are passionate. All of these experiences will help you to become a better listener, collaborative thinker and, ultimately, a better leader.
  • Find Ways to Make a Meaningful Impact: Get involved in projects, programs, committees and organizations to which you can meaningfully contribute. Volunteer to help teams working to create bottom-line change so that you can illustrate contributions to reducing costs or turnover, streamlining operations, or improving revenue. According to a survey conducted by the American Hospital Association, more than 80% of hospital executives see transformational change/change management among the most critical leadership skills; innovative thinking/creativity and critical thinking/strategic planning were not far behind. Involvement in teams with impactful goals and outcomes will help you to hone these skills.
  • Become a Resource: Listen to mentors, colleagues and co-workers and educate yourself about the financial implications of the healthcare changes. Write op-eds and seek out interview and lobbying opportunities. According to a June 2015 article published by Hospitals and Health Networks, “In a rapidly changing field, effective leaders require ‘learning agility’ and emotional intelligence’ as much or more than traditional skills.” Aspiring physician leaders must be visionary, with a comprehensive knowledge of healthcare’s evolution. They must exhibit strong communication skills, change management skills, emotional intelligence and technical/financial skills.
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