“Are you leaving already”? I was heading out the door of the hospital at 5:30 pm after my day that began 12 hours earlier. The observer was a physician I worked with, though not very closely. ”It must be nice to be an administrator and leave early while some of us have to stay to take care of patients”, he said with a smile.
While this comment was tongue-in-cheek, it boldly called out one of the many underlying judgments and assumptions that exist within healthcare. Assumptions around opposing agendas based on different roles within an organization are pervasive and contribute to the elimination of trust necessary for measurable results.
One approach to combat these judgments and assumptions is the physician-administrator partnership.
The dynamic of the Physician-Administrator Partnership is the key to efficient, innovative results or the reason behind stalled progress and frustration.
Early in my career I had the opportunity to learn from the Mayo Clinic , an organization that was built on, and therefore mastered, this partnership. This experience in an innovative healthcare environment shaped the way I view and practice this crucial relationship in all healthcare settings from faith-based to for-profit systems.
This mindful partnership is a great opportunity for both parties to learn from each other, bridge the gap between opposing perspectives and grow. Both parties must learn the art of influence to ensure the partnership remains just that, and eliminate a competitive or dependent relationship.
Maximize the Effectiveness of Your Physician-Administrative (PAP) model
Admittedly, many of Mayo Clinic’s operational success factors (e.g., aligned incentives, integrated inpatient and outpatient model, centralized budget*) seem difficult to translate to highly-competitive inpatient and outpatient markets where a mix of physician alignment models creates potential for competing incentives.
While it’s easy to look at a system like Mayo’s PAP model and think, “well, that is great for them, but would never work here”, the following are lessons from this model that can be applied to any heathcare market to increase results through accountability.
- Address “the dark side” head on: Talk about the WHY you do what you do
When physicians take on an administrative role, they often report hearing judgments from their physician colleagues of “going to the dark side” or “becoming one of them”.
I can say from personal experience that administrators unknowingly perpetuate negativity by having such packed schedules, going from meeting to meeting, that opportunities are missed to build a successful physician-administrative partnership.
The fastest way to build trust is to have deliberate conversations about the higher purpose that drew each member into the partnership.
No, this is NOT the soft stuff. It is important to understand your partner’s motivation for entering into the partnership to gain full alignment, trust – and ultimately – results.
As Simon Sinek describes in his book, Start With Why, “we are more likely to trust those who are familiar and who share similar values and beliefs”.
For that reason, it is important to share the reasons for doing what you do, what’s important to you and what you believe about how to accomplish it. This is the heart of the partnership. Having these conversations enhances the trust and connection process, producing a clear vision for success.
Ultimately, to shed light it makes sense to talk about what it’s like on “the dark side”, … and in Sinek’s words, “we must start with Why”.
- Define expectations, roles, & strengths: Success is in the details
These factors seem obvious. Discussions around them are held during the interview process and are likely outlined in job descriptions or position justifications.
However, it isn’t until the factors of roles and strengths are discussed face-to-face that the value in their definition is realized. When these factors are overtly discussed, opinions, values and beliefs will surface that ensure transparency in the partnership.
Specific issues surface in face to face discussions.
Without discussion in a safe environment, potential exists to step on toes, overlook accountability and be off mark for desired results. Everyone has unique perspectives, strengths and opportunities to grow. Instead of hiding behind those qualities, discuss them openly to understand how they complement the PAP’s mission and where your skills can be most effective.
Dialogue fosters opportunity to learn new skills and grow aspects of complementary strengths that illuminate your partnership. Consider engaging a healthcare industry facilitator who will probe for answers to heretofore harder-to-discuss issues that bring clarity to any new or seasoned partnership.
The facilitator will help your organization by defining the following:
- Why is this partnership in existence? What does success look like?
- What role does each member of the partnership play in the delivery of that success?
- Define the unique attributes that each person brings to the role. Define your attributes as well as those of your partner.
- Where are they similar?
- Where do they differ?
- Did your partner observe a strength that you had not realized you brought to the partnership?
4. Define the skills each member needs to develop to ensure success.
5. Brainstorm common scenarios to walk through the role of each individual: For example, a crisis situation, a disciplinary situation or a strategic roll-out.
- Acknowledge the impact of competing incentives
In a world of multiple physician alignment models, dual administrative and clinical roles & multiple hospitals serving a particular physician leader or practice, there are bound to be competing incentives that get in the way of a successful, accountable and efficient partnership.
Be specific in defining the potential competing incentives. Are the competing incentives financial, time-or value-based? Note that by defining the competing incentives, you are not required to solve them. The purpose is to promote authentic dialogue about the facts, constraints, and incentives or influences so that they do not become the elephant in the room when the PAP runs into obstacles.
By implementing the three simple steps outlined above, you will experience an openness to seek resolution when disagreements arise, spend less time worrying about what others are doing or saying and unleash more accountability and impact results.
The physician-administrator partnership model
provides a safety net for both parties.
The PAP model offers a tremendous opportunity for professional growth. When implemented purposefully, the PAP model combines the best of both disciplines and seamlessly anticipates and overcomes obstacles, leading to aspired results.
*Mayo Clinic Proceedings, 2001, John Herrell “ The Physician Administrator Partnership at Mayo Clinic”
http://www.mayoclinicproceedings.org/article/S0025-6196(11)62092-2/abstract
Carrie Koh is a consultant, healthcare administrator and Interpersonal Efficiency coach with a passion to change the way we connect to one another in healthcare to ensure efficient results for patients and greater fulfillment for each other. Carrie welcomes you to connect at www.carriekoh.com
Recent Comments