Having presented a general overview in our initial blog entitled “Physician Integration: A Critical Success", it is now time for us to reflect on the first question in our four part series:
Why is physician integration so critical for present and future success?”
It is becoming increasingly clear today that a successful and sustainable hospital or health system will be one that can prove, by clearly defined and appropriate metrics, that they are delivering high quality and safe care, while simultaneously reducing costs and improving accessibility. These goals and their achievement must be imbedded into the health system’s strategic goals and operational performance. Although the accountability for the monitoring of the successful implementation of these goals is done by the Board of Trustees and the Management Team, the ability to achieve these goals is, in reality, predominately dependent on the physicians’ practice styles.
Physicians drive the quality and safety of the clinical outcomes in concert with the nurses and other members of the care team. To enhance quality they must actively participate in the care institution’s care management processes, supporting the utilization of evidenced-based medical treatment protocols. In addition, they must support population and preventive medicine programs, move appropriate services to efficient and safe outpatient areas, and lead in the designing of pathways of care that improve accessibility and level of service satisfaction for patients and their families.
As important as they are to quality improvement, the physicians are also a critical driver of the cost of the various healthcare processes and treatment plans. Doctors write the orders, utilize supplies, determine the level of support staff utilized, and demand the latest and safest clinical technologies. Hence, the Value Equation – Quality over Costs - is driven significantly by physicians. Therefore, the degree of integration of the practices, protocols and processes of the physicians associated with the hospital or health system, whether employed, contracted, or credentialed as independent practitioners, with those of the hospital or health system will parallel the degree of present and future success for both. They must eventually agree that “we are all in this together and, as such, will win or lose together”.
Having been a physician for 46 years and having the opportunity to work in numerous leadership roles with physicians of all types and specialties, I know that physicians desire the best clinical outcomes for their patients. Physicians know that this requires the best nurses, ancillary caregivers, and support staff. They recognize that treatment plans driven by evidence-based medical protocols result in best practices and cost-efficient care. And they also know that excellent care is a necessity, not a luxury, for all they serve.
In the end, it is critical that the Board of Trustees, the Executive Leaders, the Management Teams, the physicians, and all other employees have the same vision, strategies and operational goals. By being fully integrated into the plans to achieve these goals, the physicians will position the health system for the best chance at future success. By uniting their voices with the Board, C-Suite, Directors, and Managers, physicians will enhance the team’s ability to rapidly address the complex challenges in today’s health care environment, driving toward successful solutions.
Now, better understanding the critical nature of physician integration today, we would suggest that it will become more important as the future unfolds. Why?
1. Because the pressure to decrease costs will significantly accelerate due to declining reimbursements both from the private and governmental payers, thus increasing operational losses from the supply and labor costs;
2. Much more clinical input will be required to select appropriate technologies that will be effective in supporting the value equation;
3. Significant physician input and support will be required to grow care management processes, population health approaches, and preventive medicine programs; and,
4. With the ever growing aging population, physicians will be needed to develop and support medical homes, hospital-at-home, and robust end-of-life programs.
Physician integration is critical in assuring that health care has the potential to meet the ultimate objective of high quality, low cost, affordable care. But, it has also been shown over and over again, in hospital after hospital, that physician integration is hard to achieve. How can this be done in an easier fashion? This question will be addressed in the next Blog in this series.