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How Do Physician Led Organizations Respond to Change?

Physician LeadershipThis blog post is a companion a Voice America interview with Robert Falcone, MD in which he talks about his career progression and his current role as CEO of the Columbus Medical Association. This organization epitomizes the change effective organizations need to make to thrive and continue to meet their missions. Much of the content is drawn from the Innovative Leadership Workbook for Physician Leaders by Metcalf, Stoller, Pfeil and Morrow-Fox.

“Leadership plays a critical role in any health care organization’s long-term success, and innovation has become a strategic necessity in today’s health care environment. In short, physician leadership and innovation have a greater impact today than ever before. Despite the volume of resources exploring both leadership and innovation, most approaches provide merely anecdotal directional solutions that lack sufficient information to actually allow leaders to make measureable change. Add to this equation the impact a diverse workforce and increasing competition have on health care organizations, and leaders face an even greater challenge.

As the health care landscape becomes more complicated, the need for strong leadership increases at an ever-increasing pace. Physician and hospital leaders face more complex challenges as health care reform moves forward along with increasing competition and downward price pressures. The annual survey of top issues confronting hospitals, conducted by the American College of Healthcare Executives’ (ACHE’s) in 2012, asked respondents to rank eleven issues affecting their hospitals in order of importance and to identify specific areas of concern within each of those issues. The survey was sent to 1,202 community hospital CEOs who are ACHE members, of whom 472, or 39 percent, responded. Financial challenges again ranked No. 1 on the list of hospital CEOs’ top concerns in 2012, making it their No. 1 concern for the last nine years. Patient safety and quality ranked second. Health care reform implementation, which had been the No. 2 concern since it was introduced to the survey in 2009, moved to No. 3 in 2012. (www.ache.org/pubs/research/ceoissues.cfm)

In this continuously changing environment, the importance of strong physician leadership is accelerating at the same time that many physician leaders are retiring.

One primary reason for a potential leadership void is the pending retirement of the baby boom generation. Health care organizations have only recently begun to invest in developing their leaders. A 1995 survey of 122 CEO’s of healthcare institutions discovered that 31% of these organizations offered in-house leadership programs. In 2002, the health care industry spent only 1.25% of their payroll on training and development while the top corporations spent 4% of payroll on these activities

—Hopkins, O’Neil, FitzSimons, Bailin, Stoller

Leadership and Organization in Healthcare: Lessons from the Cleveland Clinic, 2011

With this rapid rate of change, questions on how to lead and where to innovate remain puzzlingly philosophically: What is the role of physician leadership in a time of looming uncertainty? How will organizations innovate to overcome challenges that are largely unprecedented? In a new climate of business, is there a formula for creating success in both areas?

Every system, including the human operating system, is built to get the results it gets. Moreover, every system has a design limit, which when reached cannot be surpassed unless it undergoes transformation. For human beings, reinvention means new ways of being, thinking and acting. Not surprisingly, reinvention and mastery are tightly linked. All of us, regardless of our talents, must learn to lead ourselves. “Conventional thinking”, writes Lee Thayer, “always and inevitably leads to conventional results” (Thayer, 2004). Slowly but surely we are learning that the process of transforming ourselves and our organizations is not just about acquiring more knowledge or changing our business strategy but also about exposing the hidden contexts that shape our ways of being and acting and limit our opportunity set for leading ourselves and others more effectively. Change resides in new ways of being, talking, and acting, which are shaped by our underlying yet hidden beliefs and assumptions (Souba, 2009). The kind of learning required to shift our worldviews is enormously challenging, but it is essential for effective leadership in health care given the enormous disequilibrium and turbulence in the environment.

—Wiley W. Souba, The Science of Leading Yourself: A Missing Piece in the Health Care Transformation Puzzle, 2013″

For leaders charting the course for the organizations impacted by the major changes in health care, it is critical that they look at both their leadership approach in this dynamic environment. The Columbus Medical Association is one organization proactively setting the course for these changes and Robert is a great example of a leader who has continually reinvented himself as he faces each successive organizational challenge.

To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. We also offer several workshops to help you build these skills.

About the Columbus Medical Association

The Columbus Medical Association (CMA) has had a rich and honored history in central Ohio dating back to 1892. As it approaches its 125th anniversary, a compelling story of physicians who have come together to better serve the residents of the community can be told. Decade by decade, physician members of the CMA (formerly called the Academy of Medicine of Central Ohio) collaborated on issues that had an impact on patients locally and sometimes nationally. One of many highlights was the coordinated effort to administer the polio vaccine to the community in 1955.

In addition to the many ways the CMA physicians have responded to community needs, its membership has also looked ahead to find ways to proactively address issues that impact the health of central Ohioans. Indeed, the Columbus Medical Association Foundation (CMAF), Physicians CareConnection (PCC) and Central Ohio Trauma System (COTS) are all affiliate organizations of the CMA that were born from the vision of CMA members and are now thriving organizations serving community needs.

Today, physicians are more diverse and are practicing in an immensely more complex health care environment than they were in 1892. However, CMA physicians continue to look for ways to improve the health of their patients and the central Ohio community through advocacy, education and old-fashioned compassion.

 

CEO Perspectives: Changes in Primary Care

Changes in Primary Care1This blog was written as a collaboration between Maureen Metcalf and Jim Svagerko. It is a companion to the VoiceAmerica interview featuring Bill Wulf, MD and Jim Svagerko MA, PCC, talking about the leading work Central Ohio Primary Care with 300 physicians is doing and preparing for health care reform and new innovations in medical care over the next five years, and how it became a leader in their field and what they are doing to shape how the field of medicine and how it is practiced.

According to the Community Action Network, “A healthy community reflects a sense of mental and physical wellbeing and is the foundation for achieving all other goals. Good health is often taken for granted but is essential for a productive society. For example, every community needs a healthy workforce upon which to build its economy and healthier students are more equipped to learn and be successful academically.”

While the business of healthcare is run by physicians and administrators, health impacts every one of us. It is our responsibility to own our individual health because it effects our ability to enjoy life. Many of the challenges we face are a direct result multiple factors within the economy, and some health issues are a consequence of socio-economic disparity. Insurance plays a role when sometimes it is difficult to get access to the highest quality healthcare with the limitations on coverage. Additionally, factors in families and schools can play a role when adverse childhood events leave a lifelong impact on overall health. Injurious childhood events often contribute to mental health and drug and alcohol issues later in life. Often, the cycle continues. Many of these factors are interrelated and solving them requires cross-sector focus on community health. Communities like Franklin County in Columbus, Ohio, have strong collaborative processes to address these complex issues.

While each of us plays a role in our own care, the linchpin of health care delivery has been determined to be the primary care physician. Dr. Wulf is the CEO of Central Ohio Primary Care (COPC), a group of 300 doctors at 50 offices in four counties. His clinical interests are preventive care, population management, and maintaining a continuum of care for COPC patients. As the CEO of an organization that is nationally known for its exceptional care and innovative business model, he continues to look at what COPC will do next to meet patient needs in the context of a dynamic health care environment. Here are a few of the changes COPC is talking about:

  1. Move from pay for service to pay for outcomes: COPC is beginning to be paid for creating value for patients as they move from strictly fee-for-service payments. This shift completely changes how medicine is delivered and how doctors and all professionals associated with care delivery focus their efforts. COPC has taken a comprehensive approach to change that considers the overall system and how practices operate, the culture that encourages procedures as the foundation to manage risk, and physician scheduling and daily activities.
  2. Move to a culture of vibrancy and collaboration: Significant change is enabled by a culture of mutual respect and collaboration where all team members are encouraged to voice opinions.
  3. Leadership development: COPC has invested in physician leadership development through a variety of methods. Metcalf & Associate’s Maureen Metcalf and Jim Svagerko were engaged to support COPC, and assist them in their development. They guided the leadership team through their own personal development as well as a deep dive into the workings of COPC. Maureen and Jim will continue their work with COPC this summer and fall. In addition, COPC sends their physician leaders for education through a local professional association and their leadership team is using the Innovative Leadership Workbook for Physician Leaders, supported by Metcalf & Associates, as a team activity along with peer coaching to support growth and development, as well as promote a culture of growth and mutual support during its transition.

One of the key trends we see in health care is a shift in focus from the “all-knowing” physician to patient owning health outcomes. We are seeing a dramatic increase in “wearables”, everything to medical devices like an insulin pump to the standard Fitbit® and calorie counting apps. Many of us are using these devices to manage our own behaviors. Primary care physicians and other healthcare professional are also using these apps and the data they provide to manage the chronically ill.

It is crucial that leaders in health care arm themselves with resources to assist them as they move through these undefined areas. It will be necessary for leaders to first gain an understanding of their leadership style and abilities before they can hope to lead others. One way is through careful discernment with an executive coach/advisor to explore and present opportunities for the leader to move into a space that will allow them to create a climate and atmosphere that will serve future health care needs.

SO….what can you do about becoming more effective? To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. We also offer several workshops to help you build these skills.

About the author

Maureen Metcalf, founder and CEO of Metcalf & Associates, Inc., is a renowned executive advisor, author, speaker, and coach who brings thirty years of business experience to provide high-impact, practical solutions that support her clients’ leadership development and organizational transformations. She is recognized as an innovative, principled thought leader who combines intellectual rigor and discipline with an ability to translate theory into practice. Her operational skills are coupled with the strategic ability to analyze, develop, and implement successful strategies for profitability, growth, and sustainability.

In addition to working as an executive advisor, Maureen designs and teaches MBA classes in Leadership and Organizational Transformation. She is also the host of an international radio show focusing on innovative leadership, and the author of an award-winning book series on Innovative Leadership, including the Innovative Leaders Guide to Transforming Organizations, winner of a 2014 International Book Award.