Establishing positive physician-hospital alignment: 5 keys to success

More and more, physicians are aligning themselves with hospitals. While ideally these relationships should be symbiotic in nature, they often fail to reach their full potential as a result of misaligned goals and expectations.

Physicians seek alignment models with hospitals for various reasons, including security and sustainability, economics and clinical activity, Tony Tedeschi, MD, CEO of Weiss Memorial Hospital in Chicago and CMO of Tenet's Northeast Region Chicago market, explained at Becker's Hospital Review's 6th Annual Meeting in Chicago.

However, physicians and hospitals may experience difficulties working together — whether in an employed model or not. According to Dr. Tedeschi, one of the biggest possible pitfalls of physician-hospital alignment is physicians' lack of trust in the hospital.

"I once sat and met with a few physicians and we couldn't even talk about alignment because they had a story to tell, and that was that they couldn't trust the hospital," said Dr. Tedeschi. "In the past, the hospital had done things that were solely financially beneficial to itself."

While the physicians Dr. Tedeschi were talking to were referencing events and a perception of the organization from years before he became CEO, he realized that without acknowledging and apologizing for the hospital's treatment of the physicians in the past, they would not be able to move on.

Other possible snares to physician-hospital engagement include high turnover of the leadership team, leadership not following through on promises, a general lack of trust and an antagonistic relationship with the administration.

According to Dr. Tedeschi, there are five key pillars of success in engaging physicians and strengthening alignment with hospitals. These include:

1. Reorganizing and creating new structures

2. Alignment of incentives on a pay-for-performance system

3. Clinical leadership development opportunities

4. Open and clear communication

5. A culture of transparency

Hospitals and physicians both seek to improve patient care and satisfaction. Giving physicians a seat at the table and a voice in a dialogue will help ensure physicians support new plans and there will be co-management success. While physicians are not trained in hospital management, they are a quick learners. They can help with staffing models, business development activities and equipment recommendations, according to Dr. Tedeschi.

Gail Peace, CEO of Ludi, a company that helps hospitals and health systems actively manage physician activity through virtual automation, said physician-hospital alignment requires ongoing proactive management. There is a continual cycle of assessment, reviewing goals and identifying inconsistencies between hospitals and physicians, recommendations, redesign and re-clarifying goals, analysis and feedback.

"It is important to clearly outline duties and goals with physicians and review the work performed to assess progress," said Ms. Peace. "Then we can ask, 'Did we improve what we want to improve?' If not, we are faced with a choice when it comes to the physician. It may be necessary to reevaluate if goals are really aligned."

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