As the COVID-19 surge once again redirects resources to intensive and emergency care at the expense of surgical and clinic volume, hospitals face a growing tension over how to lead through the crisis. Our fragile system now has a spotlight on the interdependencies between clinical, operational and financial performance, with few leaders facile in all three domains.
Hospitals need physician leaders to help define the path forward, utilizing their expertise, vantage point and ability to influence key peer relationships. Unfortunately, hospitals have long struggled to build a pipeline of rising physicians with the necessary mix of clinical, administrative and leadership prowess. Poor engagement has been and remains a key culprit.
Ensuring hospitals have every capacity to meet the immediate crises, and those to come, requires that they prioritize engaging their physician leaders and building their capacity to lead. This cannot be done haphazardly, but through a deliberate and strategic approach with actionable steps, including:
Clarifying the contract
Physician contracts are famously nonspecific when it comes to the “soft skills” that comprise professionalism and the areas of culture-setting that fall outside compliance and regulatory guidelines. It is critical that hospitals take a new approach, setting clear expectations for the role physician leadership will play in advancing enterprise performance. This involves making explicit a new agreement that includes the perspective of the executive leadership team as well as the medical group and board.
Creating a powerful agreement means defining the legitimate boundaries and the clear intersections of roles, responsibilities and accountabilities in the agreement. Executives and the board must be willing to clarify how they will balance shared accountability with respect for physician autonomy, and be willing to have a true partnership with the physician voice at the table.
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Building the partnership
Physician leaders will need to cultivate a team of key administrative and clinical partners in order to drive clinical, operational and financial success. Intentional partnership means being willing to measure the strength of the relationship and attend to trust, while also nurturing foundational elements that drive success, including role definition, aligned goals, norms/commitments and collaboration/communication. Best practices like regular meetings, metrics and descriptive analytics must not be overlooked.
Cultivating the skills
The business management savvy needed to run a medical practice does not address the complex interdependencies in leading an enterprise. Preparing physicians for leadership at that level involves helping them navigate in the organization, strengthening their self-awareness and impact, and progressing their perspective to a strategic view. It also involves helping them shift from expert to enabler, with an eye toward diverse and capable teams. This requires engaging them earlier and more often in project teams, leadership roles and ways of engaging with administrative leadership “on the same side” of the table.
Of course, it remains true that physician leaders are best engaged when they enjoy a trusting and productive relationship with the administration. This has become increasingly vital in the age of COVID-19.
As we move through and eventually past the pandemic, hospitals will inevitably return to prior ways of operating. They would be unwise to continue overlooking the full engagement of physician leaders. Their cultures, organizational performance and ability to manage future crises depend on it.
Jennifer Perry is managing principal at FMG Leading. She focuses on meeting the human capital needs of the company’s growing portfolio of healthcare clients, while consulting on large-scale change, team and leader development. Leslie Solomon, Ph.D., is healthcare director at FMG Leading. She helps leaders and organizations design, measure and maximize the impact of their human capital.