Category Archives: Leadership Medical Staff

Physicians lack trust in hospital leadership

Posted on by • Posted in Health System, Hospital, Hospital Industry, Leadership, Leadership Medical Staff, Leadership Physician, Leadership Physician Alignment, Leadership Transparency, Leadership Trust, Physician Employment, Physician Leadership, Transparency, Trust • Leave a comment

https://mailchi.mp/c02a553c7cf6/the-weekly-gist-july-28-2023?e=d1e747d2d8

A recent physician survey conducted by strategic healthcare communications firm Jarrard Inc. uncovered a startling finding: only 36 percent of physicians employed by or affiliated with not-for-profit health systems trust that their system’s leaders are honest and transparent. In contrast, a slight majority of physicians working with investor-owned health systems and practices answered that question in the opposite.

Overall, only around half of physicians trust their organization’s leaders when it comes to financial, operational, and patient care decision-making. Unsurprisingly, doctors put the most trust in peer physicians, by a wide margin.

The Gist: While the numbers, especially for nonprofit systems, are stark, this survey reflects an on-the-ground reality felt at health systems in recent years. Physician fatigue has spiked in the wake of the pandemic.

And health system-physician relationships are also being disrupted by cost pressures, payer and investor acquisitions, and the shift of care to ambulatory settings. We’ve heard from physicians that, compared to hospital owners, investor-backed systems provide greater transparency and clearer financial goals centered around the success of the business. 

That physicians trust their peers so highly suggests a path forward: provide physician leaders with greater transparency into system performance and agency over strategy, with clear goals and metrics.

Designing physician leadership for scale 

Posted on by • Posted in Health System, Hospital, Hospital Industry, Leadership Medical Staff, Leadership Physician, Leadership Physician Alignment • Leave a comment

https://mailchi.mp/11f2d4aad100/the-weekly-gist-august-12-2022?e=d1e747d2d8

This week we met with a health system chief clinical officer who sought guidance on physician leadership structures: “We have more ‘closely aligned’ doctors than ever, but I feel like we’re really short on physician leaders to organize our medical staff around important goals and move them forward.” It’s a common concern.

One medical group president lamented the loss of connection between doctors as their group grew rapidly: “Our medical group has almost doubled in size in the past five years. When we had 300 providers, I knew every one, and they all felt like they could come to me directly. We just passed 1,000, and there’s no way I can know a thousand people, let alone have a personal relationship with them.”

As networks have grown, executives have shared their need to develop a new “middle layer of physician leaders”, who can build personal connections with frontline doctors. But for this middle layer to work, they stress, these leaders must be tightly connected with the executives who run the group and the health system and carry real decision-making authority: “Real respect is critical, and it won’t happen if they feel like a mouthpiece.” 
 
There was also debate about the right candidate for the job, in particular, the need to have younger physicians, who can relate directly to the needs of their peers, in leadership roles: “It took us a while to realize that the profile of our traditional medical staff leader, an older doctor nearing retirement, wasn’t working when we’re looking to lead a ‘majority millennial’ medical group.”

Regardless, every medical group agreed that they needed to identify and train more leaders, and create roles to bring them into leadership earlier in their careers. But many questions remain about how to design leadership roles. How many frontline providers can a leader work with? How should leadership structures span employed and aligned independent doctors? And how should leaders weigh same-specialty alignment versus cross-specialty collaboration? If you are thinking through these issues, we’d love to hear from you about what is working, and what challenges have emerged.