Q: What characteristics should hospitals focus on when recruiting physicians?
Connie Curran: It’s important for hospitals to get all the information they can on the physician’s history of quality. This means more than malpractice suits. Hospital boards need to know how the physician measures his or her own quality and the things that he feels define him as quality practitioner. That lays the groundwork right up front. In addition, I would want to know what data the physician has about patient satisfaction and his or her own performance relative to patient satisfaction.
Related to issues of pay, for hospitals in areas with many poor patients who don’t have the ability to pay, I’d also want to find out about the physician’s willingness to take on Medicaid patients. I’d also want to know the physician’s philosophy about things like taking call or participating in hospital activities that are not paid. For physicians that are not employed by the hospital, if they’re not taking care of patients in the traditional sense, they’re not getting paid. You should consider: Does your hospital pay for call? Do you pay for physicians to participate in quality committees or to attend medical staff meetings? It could be a big plus for your hospital if you can say, “We don’t expect you to take free call.”
Q: How can you gauge a non-employed physician’s stance on performing tasks other than caring for patients, for which they might not be paid?
CC: I think it’s important to say, up front: “We really respect your time and we know when you’re not taking care of patients you’re not making money. However, in our system we expect that from time to time you’re going to participate in some of the decisions about running this hospital.” You need the doctors to participate in those decisions, so it’s important to get a sense right up front about their feelings about this.
Q: How can hospitals work to align physicians with their goals, either during recruitment or after the physician has joined the hospital?
CC: This is really a reciprocal issue. You want to learn about the physician’s goals and you want to see how you can further those goals. For instance, I do a lot of work with surgeons and I know that surgeons want state of the art equipment that is readily available and in first-class working order. They also want ample, trained staff to get the show on the road. So, if you say: “What are your goals?” and the physician tells you it’s these things, then you can say: “Those are our goals too, and we also expect that you will treat staff in a professional manner, that you attend to patient satisfaction and that you handle your end of the paperwork.”
It depends what’s important to your hospital. The point is that this is a reciprocal relationship. It’s a mutual alignment of goals where the hospital makes a commitment to help the physician achieve his or her goals and the physician makes a reciprocal commitment to the hospital.
Q: How is the role of hospital boards going to change in the coming years as the healthcare industry changes under health reform?
CC: The board’s role is critical and is becoming increasingly so. It all starts with the board setting the values, vision and mission of the hospital, and the goals of the hospital. The board has to be clear about this so that when physicians are recruited, they are recruited in alignment with these things. The roles of boards are changing radically with everything from the new monitoring of quality to the enormous transparency that both the government and private payors are requiring. Boards must be much more sophisticated about issues related to quality and finance than they’ve ever had to be in the past. Hospitals, in turn, must be more sophisticated in terms of physician recruitment and in actually monitoring physician performance.
Q: How is physician recruitment changing with an increasing focus on quality measures?
CC: We want physicians who understand the hospital board’s authority and accountability and who can work comfortably as part of a team with hospital executives, board members and other physicians.
I think that all physicians who are practicing today, and going forward, will have as their first priority the quality of care. It has to be.
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