In This Issue
Message from your ACHE Regent, Fall 2016
Message from the Chapter President, Fall 2016
Original Articles by ACHE Members
Physician Partnerships in the Age of Healthcare Transformation
Collaborative Partnerships - ACHE, AONE, and HSCN
Chapter Events
Leadership in Action - Partnering for Success: The 2016 AONE Hawai'i Conference
Calendar of Events for Fall 2016
Education Calendar for Fall 2016
News & Committee Updates
News from the Education Committee
Membership: New Fellows, Members, and Recertified Fellows
News from the Guam Program Council
Fall 2016 Financial Report
ACHE National News - Fall 2016
Career and Leadership
Career Corner
Ensure delivery of Chapter E-newsletter (Disclaimer)
Many thanks to our Sponsors!
Collaborative Partnerships
Physician Partnerships in the Age of Healthcare Transformation
Dale Glenn, MD

Perhaps never before has the need for successful partnership between administration and physicians been more important than during the great age of healthcare transformation. Since 1910, when the Flexner report was published, government regulation of healthcare has expanded exponentially.  Physicians who traditionally spent nearly all their time caring for patients now need to give equal weight to satisfying compliance requirements, meaningful use, PQRS, preauthorizations, quality metrics, HCC coding, patient experience, and a plethora of other metrics coming soon to a computer near you.

To succeed we must find common ground.  In addition to my clinical practice, I have been involved in various leadership roles while installing an EMR for multiple hospitals,  establishing a population health program, setting up the Hawaii Health Partners Accountable Care Organization (ACO), serving as chief of my department, and on the Hawaii Pacific Health Board of Directors.  I have had the opportunity to gain perspective from both clinical and administrative sides of the fence.  Nevertheless, because I still find reading an Xray to be easier than reading a budget, I have learned first hand that partnership is critical to transforming healthcare.  Hopefully the following suggestions will assist you to build successful physician-administrative partnerships.

1.  Its about the patient.  While physicians may have their own agendas, for the most part people who choose medicine do so in order to be a benefit to society.  Assume good intentions. You should be clear on what your shared mission is, and how your partnership will help achieve it.  The formula relationship, task, relationship is also beneficial in establishing trust.

2.  Have an effective change management model.  Whether you use Kotter, have recently read Dan Heath’s Switch, or my personal favorite, the Knoster Model, you will see change is a process, not an event.  Change is far more emotional than it is intellectual.  Individuals adapt differently to change, and so does culture.  Rolling workflow changes out "big bang" will be met with resistance from the late adopters and curmudgeons unless you demonstrate success using pilots among known early adopters.  These pilots can then be used to convince thought leaders that the change is not only practical, but bearable.  So before burning any platforms, have your firefighting gear in place.

3.  Doctors respond well to clinical data.  Medical school is all about anatomy, physiology and biochemistry with a little psychology to round it out (though bedside manner is making a serious comeback).  Any opportunity to show that a process truly improves the health of patients will be met with less resistance.  For instance HCC coding isn’t about medicare reimbursement, it is about identifying the sicker patients within a practice so we can get them get better resources.  Meaningful use, done correctly, helps patients communicate with their doctor and understand their diseases better.  These statements are only useful if supported by data.  So do your internet searches and be prepared to show the positive impact of your proposal on patient care.

4.  Seek to understand then to be understood.  Whether you are approaching one physician or many, effective rounding and communication begins with "what can I do to make your job easier?"  After you have sincerely understood and can articulate the challenges facing your clinicians, your own proposals will be much better recieved.  Physicians don’t have to feel like they are in control, but they do have to feel like their opinions count.

5.  Invest in effective physician leaders.  Physicians respond best to physicians. Invest in training, conferences, reading, journal clubs, to identify and develop physicians with a proclivity toward leadership.  Those with good people skills who have the respect of their peers are especially effective.  Protect their administrative time: there is no such thing as "part time clinical" because patient care issues can erupt any time day or night.

Effective physician partnerships are the key to success in this healthcare environment.  With a common mission and carefully established trust, your organization will be able to ride the waves of change to a better experience for your staff, your patients, and your full time administrators.