Compare and contrast leadership approaches for personnel in health care
HCA 3301, Health Care Management 1
Course Learning Outcomes for Unit V Upon completion of this unit, students should be able to:
6. Compare and contrast leadership approaches for personnel in health care. 6.1 Explain the key theories and models for leading in health care organizations. 6.2 Describe the key theories and models for motivation in health care.
Learning Outcomes Learning Activity
6.1 Unit Lesson Chapter 9 Unit V Project
6.2 Unit Lesson Chapter 10 Unit V Project
Required Unit Resources Chapter 9: Leading: Theories and Models Chapter 10: Leading: Motivating and Influencing Unit Lesson
Physicians and Hospitals—Leading and Motivating Doctors Today The relationship between hospitals and physicians has always been important, and it has always been somewhat challenging. Today, it takes even more planning and effort because of the changing financial relationships that are involved.
What Makes it Work Today? There was a time when physicians and hospitals truly did function at arm’s length, and they liked it that way. Hanging out the shingle saying, “open for practice” and going into business for oneself, that was a time- honored tradition in medicine. Perhaps the best thing about that shingle is—no boss. Nobody telling the doctor how to practice medicine, nobody telling the doctor how to run their office. It really was great for a very long time, but things have certainly changed. More than ever before doctors and hospitals must be on the same page, working together, for the clinical and financial success of the organization. Multiple factors drove doctors out of independent practice and into employment relationships. The cost of obtaining malpractice insurance coverage was a big one. The complexity of human resource law, and the downside risk of hiring and firing was another, coupled with the doctor’s inability to provide benefits such as health insurance; disability coverage; and retirement at a reasonable cost for themselves, family, and staff. All of these were factors.
Looking at the Numbers American Medical Association (AMA) survey data for 2019 reveal that employed physicians now outnumber private practice. The AMA’s Practice Benchmarks Survey demonstrated that 47% of all physicians in 2018
UNIT V STUDY GUIDE Leading in Health Care
HCA 3301, Health Care Management 2
UNIT x STUDY GUIDE Title
were employed, compared with 46% of doctors who were in independent practice. Employed physicians are up by 6% since 2012 (Gallegos, 2019). To better understand the trend, please note that younger physicians and female physicians are considerably more likely than older and male doctors. Today, 70% of physicians under age 40 are employees. The trend is clear. The future will hold more and more employment relationships between hospitals and doctors (Gallegos, 2019).
The Crucial Five As Hospitals and Health Networks Magazine has provided an excellent summary of the five As, which differentiate doctors and thereby give hospitals a competitive advantage. Hospital chief executive officers (CEOs) have always cared about the success of their doctors, but today this factor is so important for the hospital’s bottom line (Sullivan, 2019). Let’s look at these crucial five As in more detail. Availability – First consideration is simply making oneself available for patients. Patients will never know what a good doctor you are unless they can get an appointment to see you! Waiting time, bedside manner, courtesy, and flexibility of front office staff are so important. Practice location and quick feedback to patients is also important. A doctor who will work in a few extra patients who truly need to be seen is creating relationships that could last for a lifetime. A doctor who is out the door at 4:30 p.m. sharp each evening is missing the boat. Those patients will find someone else to see. Affability – It would be great if we could somehow bottle affability and give it to doctors. That expression of compassion, patience in listening to clients, and sense of humor goes a long way in an exceptional doctor- patient relationship. Patients just like some doctors better, and that shows up in practice performance. Ability – We definitely need to look for physicians who focus on quality, safety, and superior skill levels. They are well trained, and they have documented their experience for all concerned. They do everything for patients that they can do at a very high level. They do nothing for which they are unqualified. Affordability – At one time we stopped there, where we focused on just the three As of availability, affability, and ability, but the world has changed. Financial transparency is crucial now. Successful doctors find ways to get to the right diagnosis and treatment without ordering tests with a “shotgun.” They understand the patient’s reality, and they consider ways to reduce cost. Accountability – Finally, doctors today need to take full responsibility for their work, especially including the value added to patient care. When things do not go well, they acknowledge the problem and work hard to fix it. Patients do not expect perfection, they expect quality and honesty.
Conclusion Health care executives must lead and motivate doctors. That is so important for community health and so important for the success of our facilities. As more and more doctors come on the hospital payroll, the working relationship becomes ever more critical. A smart health care leader today will think, “how will this impact the doctors?” A smart physician today will think, “how will this impact the hospital?” There will be challenges along the way, but it is teamwork that is perhaps the most important in all of health care.
References Gallegos, A. (2019, May 6). Employed physicians now outnumber independent doctors. MDedge.
https://www.mdedge.com/hematology-oncology/article/200319/practice-management/employed- physicians-now-outnumber- independent#:~:text=The%20AMA’s%20annual%20Physician%20Practice,were%20self%2Demploye d%20that%20year.
HCA 3301, Health Care Management 3
UNIT x STUDY GUIDE Title
Sullivan, K. (2014, June 19). 5 A’s of successful physician employment, alignment. Fierce Healthcare. https://www.fiercehealthcare.com/healthcare/5-a-s-successful-physician-employment-alignment
Suggested Unit Resources In order to access the following resource, click the link below. The hospital organizational chart shows the CEO at the top, but physicians also have a lot of leadership roles in our facilities. To learn more about the physician as a leader, read this article from McGill Journal of Medicine. Carsen, S., & Xia, C. (2006). The physician as leader [Editorial]. McGill Journal of Medicine, 9(1), 1–2.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687888/pdf/mjm9_1p1.pdf Learning Activities (Nongraded) Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit them. If you have questions, contact your instructor for further guidance and information. The Chapter 9 Matching activity reinforces information on the lesson content that you will find helpful. A PDF of the Chapter 9 Matching activity is also available. The Chapter 10 Click to Reveal Terms activity reinforces information on lesson content that you will find helpful. A PDF of the Chapter 10 Terms activity is also available.
Required Unit Resources
Physicians and Hospitals—Leading and Motivating Doctors Today
What Makes it Work Today?
Looking at the Numbers
The Crucial Five As
Suggested Unit Resources
Learning Activities (Nongraded)