Prescription for Change

3 ways to improve physician leadership

by Chloe Lewis

Nearly every physician executive we speak to is focused on improving physician leadership. 70% consider it a top time-consuming priority over the next three years, and with good reason: it will be difficult for health systems to thrive in a value-driven market without effective physician leadership at the helm.

“There's no question that physician leadership in general is being increasingly viewed as an essential requirement for excellent performance for health systems.”
—John Hensing, CMO, Banner Health

Frontline physicians are focused on leadership, too. In our 2014 Physician Leadership Survey, physicians cited the ability to influence system strategy and improve patient care as top motivators for seeking out leadership roles.

Organizations are responding to this strategic urgency and physician interest by investing an average of $100K per year on physician leadership training.

But physician executives from across the country tell us they are not seeing the desired return on investment in physician leadership. One CMO reports that her organization spends $2.2M on stipends every year, but says “it is unclear what any of these leaders actually do.”

So where’s the disconnect?

We see two key problems. First, physician leadership roles are poorly defined and designed, meaning neither the roles nor the responsibilities are clear. Medical directors and department chairs, for example, often have overlapping job descriptions and insufficient awareness of one another’s goals.

Second, physician leaders are working in leadership structures that have developed ad hoc over a century. This results in unclear reporting lines and poor alignment between system-level physician leaders and entities, like the medical group and clinically integrated network. Even the most capable leader will struggle to excel in a dysfunctional system.

The good news is that some organizations are effectively leveraging their physician leadership to meet today’s strategic demands, tackling physician leadership in three key ways:

1. Scoping top-of-license physician leader roles.
Too few organizations utilize their physicians at top-of-license. Physicians are the “brain trust,” as one CMO called them, of any organization. Take advantage of their clinical expertise and problem solving abilities by clearly scoping their role, and then pairing them with an administrative or nurse leader. Make it a true partnership by having them mutually accountable for shared goals.

2. Increasing physician leader role focus and accountability.
Physician leaders are often left out of their organization’s strategic planning, which can leave them feeling disconnected from broader system goals. Sharpen the focus of physician leaders’ roles by including them in system-wide goal cascades, communicating priorities from the executive level down to the front line. Follow up by creating an assessment process that measures physician leadership performance and potential. Where appropriate, tie physician leader goals to at-risk pay.

3. Aligning the leadership structure with system strategy.
Due to myriad relationships between system entities, such as the hospital, medical group and clinically integrated network, physician leaders rarely have the opportunity to participate in shaping one another’s strategic agendas or broader system goals. Improve the development and delivery of a unified system strategy by including physician leadership from disparate system entities, as well as site-, facility-, and system-level leadership in this strategic planning work. Consider the possibility of having a chief physician executive with system-wide oversight to improve the alignment of siloed physician leadership structures.

Get more insight into physician leadership

We'll be offering tactics and tools for senior physician leaders to execute on these three strategies at our 2014-2015 national meeting series.

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