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Someone Needs To Run The Asylum: Why Physician Leadership Is The Answer.    

We physicians are understandably worried that the push to save money in health care will compromise the care of our patients.

We have witnessed botched attempts to balance the health care budget on the backs of providers and patients: arbitrary reductions in length of stays, denial of payments for "unnecessary" procedures, capitation, etc.

Physician leaders have an opportunity today to lead the way forward to improve care and save money. The solution is quality, measured by patient centric metrics. Physician leaders need to set the bar high and demand consistent patient centric quality care from all of their colleagues.

A true story (the names have been changed to protect the guilty) serves as an example of an opportunity to increase quality and reduce health care costs.

Physician Leadership and Pornography    

Physician Leadership and Pornography: we know it when we see it.

In the most frequently quoted Supreme Court opinion on obscenity, Justice Potter Stewart remarked, "I shall not today attempt to define the kinds of material I understand embraced within that shorthand description (pornography); and perhaps I could never succeed in intelligibly doing so, but I know it when I see it...

Justice Stewart was tasked with looking at a fair amount of pornography before coming to his conclusion (no pun intended). Physician Leadership, like pornography, may be hard for some of us to define, but most of us recognize it when we see it.

Leadership Lessons Learned From Childrearing    

Effective parenting, like effective leadership, is a demanding, often emotionally draining task.

I have attended leadership courses and conferences, read many books on leadership and many biographies of people I admire as great leaders: George Washington, John Adams, Alexander Hamilton, Thomas Jefferson, Abraham Lincoln, Teddy Roosevelt, Winston Churchill and Martin Luther King. I have been privileged to hold leadership positions in my practice and in my community. While I have learned from all of these sources, I credit my children with teaching me the most about what it takes to lead..

My wife and I, both physicians, have been blessed with four wonderful children. (The woman just couldn't keep her hands off of me). It seemed to us that if we could complete medical school and survive our training, raising children would be fairly easy. Gather the data, analyze it and act upon it. It took us a while to realize that being successful parents required a lot more EQ (emotional intelligence) than IQ. The same rule applies to leadership, EQ trumps IQ. Always.

Bigger Isn't Better; Better Is Better    

Breaking The Paradigm of Quantity: A Challenge for Physician Leadership

One of my favorite Jackie Mason jokes goes something like this. A potential customer enters a store whose sign in the front window proclaims: "WE SELL NOT JUST BELOW RETAIL. WE SELL BELOW COST!". He skeptically approaches the store's proprietor and asks, "How can you manage to make a living selling below cost?" "Simple" answers the owner, "We make it up with volume!"

When I tell this joke to Hospital CEO's or CMO's they laugh until I suggest that they may be doing the same thing with their medical staff strategy: bigger is better. The bigger the medical staff and the bigger their referring volume the better the hospital's bottom line. The bigger the size of a physician's practice the better the quality of the physician. "He/she must be a great doctor, look at the size of his/her practice and how many patients he/she refers!".

Physician Leadership: Myths & Facts   

It should be obvious to all that the politicians and pundits driving the healthcare debate in this country have a surplus of sound bites and a deficit of solutions. Many cannot even accurately define the fundamental problem: COST.

The United States cannot sustain double-digit healthcare inflation, and an 18% of GNP healthcare system. Our companies cannot compete in the global market with 15-20% of their overhead going to healthcare. Medicare spending, already funded through its trust fund, without thoughtful intervention will bankrupt our country in the near future.

Healthcare Integration    

Waiting for Dr. Martin Luther King

Healthcare integration requires today what racial integration required on the 60′s: strong leadership

In one of our physician leadership training modules, we show the video of the 1963 civil rights march on the nation’s capitol with the key note speech of Dr. Martin Luther King. It is easily accessible on YouTube (search for “MLK’s I have a dream”).

The video has an incredible personal meaning for me. I remember watching the speech with my dad (he actually took the day off from work!) on our black and white RCA with its never quite focused rabbit ears, looking for faces in the crowd of friends whose parents allowed them to attend. Washington DC at that time was still very much a southern town and my overly protective parents were not willing to risk sending the center of their universe forth to do battle with the rednecks threatening to violently shut down the march.

Autonomics Anonymous    

Dealing with a disabling addiction: A challenge for physician leaders

What would you think if I sang out of tune,

Would you stand up and walk out on me?

Lend me your ears and I’ll sing you a song

And I’ll try not to sing out of key.

Somewhere in the near future we look through a one way mirror into a doctor’s lounge. Scanning the the room we see a group of anxious individuals sitting in a circle. They seem uncomfortable being here. Most look downward, trying at all costs to avoid eye contact. The one empty chair is soon filled by an energetic younger man with a clipboard.

The Value Proposition for Healthcare

In health care there is nothing more complex than the simple.

In a recent New England Journal of Medicine article, What is Value in Health Care?, Michael Porter, a Harvard trained PhD in business economics, makes a compelling case for defining, measuring and rewarding value in health care. By shifting our focus on value, simply defined as quality divided by cost, we can lower costs and improve quality.

The elegantly written article shows that value is what drives consumers.