Physician leadership is an essential element required to provide optimal patient-centered care. To succeed, health care must be quality-centered, safe, streamlined, measured, evidence-based, value-driven, innovative, fair, equitable, and physician-led.
The American Association for Physician Leadership (AAPL) is focused on the personal transformation of all physicians, and through them, the organizations they serve. With the goal of improving patient outcomes, workforce wellness, and a refinement of all health care delivery, AAPL champions the view that physicians are best suited to lead clinical efforts to achieve true patient-centered care.
It is well-recognized that, at some level, all physicians are regarded by our society as leaders.
Physician leaders provide a competitive differential because they have extensive knowledge about the “core business” of caring for human beings. They have learned, lived, and breathed patient care. They have been described as “interface professionals” who bridge medicine and management. At the edge between other physicians and managers, physician leaders can be the catalyst that every successful organization needs, connecting the organization’s so-called sharp end (the front lines of care) with the blunt end (related management, leadership, and governance).
The AAPL believes that, with the right physicians on the C-suite leadership team, the organization will be able to relate to non-physician managers as well as clinicians of several disciplines. Through the orders they place and the management they provide for patient care, physicians remain the primary drivers of care.
This does not necessarily mean that physicians should only be in titled leadership positions. Physicians of all types and in a variety of roles still provide leadership — albeit informal leadership.
A physician is certainly not needed in every leadership role — Allegro’s CIO and CFO are not medical, said to Josephine L. Young, MD, MPH, medical director of Premera Blue Cross and formerly chief operations officer for Allegro Pediatrics. In fact, “there is value in having your senior leadership team come from a non-clinical perspective as well.”
That blend of clinical and non-clinical backgrounds, including specialized expertise in information technology and finance, “allows you to treat the business side like a business and to draw from the best of both worlds,” she says.
Without exception, thought leaders in the field of physician leadership emphasize the critical requirement of building great teams and working with them effectively. But they also point out how challenging it can be for physicians to transition from the independent thinking driven into them in medical training programs to the interdependence of working with a team.
The effective collaboration of the chief medical officer and chief financial officer requires a supporting organizational structure. For example, governance structures that encourage clinical input into operating decisions foster collaborative work. A dyad leadership model, in which a clinical leader is paired with a financial leader within each relevant unit, is an effective technique for creating the capacity for shared work.
Because the transition to value-based models inherently includes quality and cost, it is a critical arena for collaboration between clinical and financial leaders. It is important to acknowledge that CMOs and CFOs speak different languages, have different perspectives, and focus on different goals. It is critical for clinical and financial leaders to recognize and understand the pain points of their colleagues on the other side of the C-suite.
Success in the value-based environment requires leaders who can bridge the gaps between the clinical and financial realms. It requires clinicians who can understand finances and can galvanize their peers around organizational or population health goals. Physician leaders speak the language and share the perspective of the care providers at the front lines of care. They can rally physicians and other clinicians in a way that other leaders may not.
Until recently, health care was primarily physician-centric and disease-focused. This focus has driven not only care delivery but also a majority of the business practices within the industry for decades. Today, there is a rapid shift to team-based approaches and population health and wellness.
As many health care organizations grapple with what a team-based approach means and how to successfully implement team-based clinical care, a variety of initiatives around the country and the world are aimed at moving the industry toward multi-professional and inter-professional team-based education.
Although physicians have moved in the direction of this new horizon, there is a long way to go. Pride in being a physician who is passionate about quality patient care is a professional expectation grounded in centuries of behavior. The pride and passion for the physician “team” will not be easily displaced — nor should it.
The entire health care industry is ultimately about patient-centered care. All health care professionals, regardless of discipline or model of care delivery they support, are playing on the same team for patients.
Although many physicians tend toward autonomy and independence, it is important to recognize that this behavior can directly or indirectly impede successful patient care outcomes.
That is why it never surprises us that an overwhelming number of top-ranked hospitals continue to be run by physician CEOs. Year after year, U.S. News & World Report’s annual “Best Hospitals Honor Roll” supports a strong connection between high-quality ratings and physician leadership.
Peter Angood is CEO and president, American Association for Physician Leadership, and author of All Physicians are Leaders: Reflections on Inspiring Change Together for Better Healthcare.