Bridging the exam room with the boardroom

Six strategies to build strong physician-administrator partnerships

A decade ago, it was rare to find healthcare administrators and physicians solving problems collaboratively. A combination of mutual respect and misunderstanding kept these experts far apart. There was often good intent behind this siloed approach — administrators didn't want to bother physicians with business meetings, and physicians needed to spend time delivering care, not explaining it.

But over the past several years, it has become increasingly clear that physicians and administrators no longer have a choice about whether to work together. In fact, it is vital to the future of healthcare that they do, melding medical acumen with strategic insight in order to save a flailing industry.

Consider the time, effort and resources devoted to electronic medical record adoption and clinical integration. Now that large-scale, chronic change is the norm, administrators are putting their organizations at great risk by not engaging physicians and other providers in the decisions that ultimately impact their work. Administrators must exercise the patience to collaborate, sort through the input and ultimately incorporate physician feedback into solutions. For their part, physicians need to avail themselves to these conversations, participate in identifying compromises and accept that the business side of healthcare isn't all bad.

Gone are the days when clinic team meetings included everyone but the physicians. Now, executive suites are filling up with physicians in roles beyond the CMO's office. Compacts, advisory councils and leadership development programs are designed to increase a physician's ability to thoughtfully participate in the business of healthcare. While all of these opportunities provide tangible and meaningful occasions for cross-discipline collaboration, there seems to be more pressure placed upon physicians to catch up than there is on administrators to fully understand what it means to practice medicine in the tangled web of healthcare.

While organizations continue relying on physicians to provide perspective and expertise, there is an opportunity for administrators to develop more insight into the impact our financially strapped, litigiously targeted and quality-challenged system has on a physician's ability to practice. Most physicians would welcome the opportunity to open up their world to administrators who demonstrate sincere levels of compassion and curiosity toward the daily pressure placed upon the average physician. After all, providing high-quality care today often means simultaneously managing a complex computer system, paying back a mountain of debt and memorizing ICD-10 codes.

Therefore, the call for integration needs to go beyond clinical teams. The success of physicians and health systems are inarguably interdependent. It's time to bridge the exam room with the boardroom.

Here are six strategies for building strong physician-administration partnerships:

1. Create rules of engagement. Collaborative decision making, problem solving and strategic planning require a strong foundation of trust. Compacts, team agreements and shared governance councils are just a few examples of ways physicians and administrators can create frameworks to coexist and begin conversations from a deeper place.

2. Measure and value the same data. What's an RVU anyway? Until those delivering healthcare measure their success the same ways as those managing healthcare, there cannot be a common definition of success. Identify three to five key metrics, talk about them, track them and highlight them. Repeat.

3. Plan meetings around patient care. Meetings should be centered around care delivery, not individual preference or precedence. Prioritizing the patient means administrators and physicians need to find alternate ways to connect with each other in order to minimize care disruption. Consider brief, but regular, huddles and longer, but more occasional, meetings. And use technology when it makes sense.

4. Start small and build momentum. Rome wasn't built in a day, and neither were clinical programs, hospitals and clinically integrated networks. Initially focusing on small, manageable projects helps cross-disciplinary teams achieve quick wins that create momentum for larger, more significant undertakings.

5. Celebrate often. Acknowledging the effort and work that has gone into an accomplishment further solidifies any relationship, as long as the celebration is authentic and meaningful. In an industry filled with solving problems, it can be a refreshing change to spend time toasting hard work.

6. Spread the word. All it takes is a few key stakeholders achieving success in order to create contagious and positive energy that will help cultivate more champions. Intentionally sharing updates, success stories and even course corrections demonstrates that administrators and physicians can successfully collaborate and achieve meaningful outcomes together.

Health systems that continue to nurture the physician-administrator dyad and embrace its potential will be leaders in an industry where many organizations are working hard just to stay afloat. This collaboration does not occur overnight; rather, it must be intentional, thoughtful and strategically incorporated into the culture and goals of an organization. Most importantly, this partnership must be aligned around a shared desire to deliver better care and create healthier communities.

Lisa Goren is program director for physician alignment and engagement at Legacy Health, where she oversees physician leadership development.


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