David O. Parrish, MS, MD, FAAFP Bayfront Family Medicine Residency.

David O. Parrish, MS, MD, FAAFP

Bayfront Family Medicine Residency

Why do we have to change?Current status of Healthcare LeadershipThe Physician ExecutiveLeadership training (in medical education)Business management training (in medical

education)How do you break down the silos (in medical

education) with respect to business and leadership training?

A pathway forward

Institute of Medicine’s Crossing the Quality Chasm Report1

Skyrocketing health care costs2

Management of health care resources3

Sources:1.http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-C

are-Quality-Initiative.aspx2.http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx3.http://www.aafp.org/online/en/home/practicemgt/reform.html

Most hospital CEOs hold a degree in Masters of Hospital or Healthcare Administration1

Types of Experience: Strategic management, business leadership, executive leadership1

Physician CEOs: 235 out of 6,500 hospitals within US2,3

Sources: 1.http://www.healthcareadministration.com/becoming-a-hospital-ceo/2.http://www.amandagoodall.com/SS&MarticletJuly2011.pdf3.http://well.blogs.nytimes.com/2011/07/07/should-hospitals-be-run-by-doctors/?seid=auto&smid=tw-nytimeswell

Who are they?1,2,3

Board-Certified MDs/DOs

What do they do?1,2,3

a. Provide administrative direction to the health care organization’s organized Medical Staff

b. Guide the Medical Staff towards the goals of the

health care organization

c. Provide administrative direction of the

health care organization

Sources: 1.http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=AHA/NewsStory_Article/data/HHNMAG245&domain=HHNMAG2.http://net.acpe.org/Resources/Articles/Reclaiming_Physician_Power.pdf3.http://www.aafp.org/fpm/1999/0700/p37.html

A formal longitudinal pathway of leadership and business training for physicians is needed

Usually undertaken by “seasoned” practicing physicians

On the job +/- formal business & leadership education

The Joint CommissionThe Accreditation Council for Graduate

Medical Education Liaison Committee on Medical Education

Limited requirement for leadership training for practicing physicians, physicians-in-training, or medical students, yet they are increasingly being evaluated on “Interpersonal and Communication Skills” and “ Professionalism”. In addition, as they progress in levels of their educational training they are being placed into leadership roles in their respective communities, health care organization, and health care associations due to their expertise.

The Joint CommissionThe Accreditation Council for Graduate Medical Education Liaison Committee on Medical Education

Limited expectations for business management education for practicing physicians, physicians-in-training, or medical students, yet they are increasingly being evaluated on “system-based practice” and managing healthcare costs.

Can be a physical impediment, however, more so an organizational and/or individual mind-set that results in the unwillingness to share or participate in a cross system manner that will benefit the overall ecosystem in which the organization and/or individual operates within.

Source: Lencioni, Patrick. “Silos, Politics and Turf Wars: A Leadership Fable About Destroying the Barriers That Turn Colleagues Into Competitors”

Accreditational: The Joint Commission vs. ACGME vs. LCME

Institutional: Inpatient vs. Outpatient

Leadership: Senior Management vs. Middle Management

Willingness of industry leaders to break silos

Working across the ecosystem of health care to develop an enhanced framework of medical education and training as it relates to business education and leadership training

Measuring the change and “flexing” with the results

“Un-Siloed” Framework for the Development of the Next Generation of Physician Executives

Start as early as possible to explain, discuss and teach not only interactive leadership skills, but the coordinated business expectations.