From the
PRESIDENT
ROBERT “BOB” H. COUCH, MD, MBA
GLMS President | bob.couch@glms.org
THE NEW PARADIGM
T
he practice of medicine is centered on
relationships. We experience many,
such as with our patients, their families, our staff, our fellow physicians, third
party payers and others. I want to talk about
our relationship with hospital administrators.
I think it is time we re-examined that connection and look at ways to improve it.
The traditional doctor-administrator relationship is at times adversarial. While we
should have shared goals, we often find ourselves pulling in different directions. Our education is different, our cultures are different,
and we think we have different objectives.
Ultimately, however, we need to strive for what
the Institute for Healthcare Improvement calls
the Triple Aim: Improving the patient experience of care; improving the health of populations; and reducing the per capita cost of
health care. Physicians and management alike
should share in these objectives.
The American Medical Association and the
American Hospital Association, the primary national interest groups for both groups,
recently came out with a paper calling for
integrated leadership for hospitals and health
systems. They both think it’s time to rethink
the traditional hospital-physician relationship.
It’s essential for more physicians to acquire
new leadership and management skills to become more effective partners with hospital
executives. We shouldn’t have to get an advanced degree, such as an MBA or an MMM,
to develop proficiency. Our MD or DO degree
should be the ultimate credential. I have an
MBA, but only because the business skills I
needed weren’t taught in medical school or
residency. We need to get better at preparing
a new generation of leaders.
The GLMS sponsors an annual leadership
course. We have partnered with the University of Louisville for the past three years to
sponsor the Residents in Business course for
physicians completing their training. U of L
offers a Distinction in Business and Leadership
track as part of their undergraduate medical
educational experience. We’ve got to do more,
though, to get all physicians thinking about
how we can use leadership skills to better integrate with health systems, important for
developing better relationships with administrative leaders.
While physicians must learn more business
skills, hospital administrators must learn more
about what is important to physicians. They
need to learn more about physician finances
and managing debt, how we make clinical
decisions, how our workflow is affected by
many outside forces, and how we see ourselves
as the ultimate advocate for our patients. It’s
crucial that they meet us in the middle. Some
of them face a long journey.
There are other forces challenging our relationships in Louisville and the region. We
have several strong health care systems that
employ many physicians. The inherent competitive nature of the interactions between
these entities can strain relationships. Everyone is looking for a competitive advantage.
We’re facing the stresses of working under
newer payment strategies. As more doctors
are being employed, we are spending less time
looking out for each other. Physicians feel they
are treated like goods and services rather than
as partners with hospitals.
It’s time to change the culture. Traditionally, we identify what we do as taking care of
individual patients. In an integrated system,
physician leaders and administrators must recognize that our goal is the health of the entire
population we serve, not just the single patient.
To be fully integrated, we must align our
values and expectations with administrators,
ultimately sharing financial incentives. There
should be collective strateg