"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Thursday, October 9, 2014

A Step By Step Guide To How Hospitals Discourage Doctors, Really?

I read a blog last week from a midwest physician who posted on KevinMD's blog page.  I am a regular subscriber to KevinMD and it has proven to be a great blog especially for physicians.  

This particular blog was about a radiologist who was waiting to see someone in administration and he finds a document that was left by a vendor / consultant.  The document was entitled, "How to Discourage a Doctor".  According to the radiologist, the document provides hospitals with tactics and proven strategies on how to better control physicians in their hospital.  He describes the contents which suggests that hospitals introduce barriers to the physician's care, increase their responsibility while decreasing their authority, no longer allow them to meaningfully influence health care decisions, promote a sense of insecurity among the medical staff, convince them that their professional judgement is no longer reliable, make health care incomprehensible through information technology, show physicians that they are no longer important in the care delivery model, transform all independent physicians to employees, insist upon the use of broad practice guidelines and subject physicians to escalating productivity expectations.  

What the blog did for me was to give me a good laugh.  When I first read the blog, I thought that it was a joke.  So, my reaction is as follows: first of all, the garbage that comes across my desk or finds it's way into my email box throughout the day from vendors/consultants is immeasurable.  Everyone's got an angle which would certainly be the case for the consultant who left this particular document.  If there are health care executives following these suggested tactics and strategies, they won't be around for long.  

Based on changes in health care today and going forward, hospitals have to find ways to better integrate physicians into the ever changing care delivery model.  If anything, the physician's role is more critical as we work to put the patient in the center of everything that we do.  Are their changes impacting hospitals and physicians, most certainly.  Are these changes at the expense of the physician, absolutely not.  We are constantly looking for ways to get the physician more involved with what we are trying to accomplish.  There are regulations and requirements that are being heaped upon hospitals (and soon to be heaped upon physicians), but we can only be successful if physicians and advanced practice professionals are part of the team.  

For example, with new IT systems, we are only as good as the extent of our medical staff's involvement in bringing such systems up.  Are we using protocols, we are and when a physician arrives who had been trained in using such protocols, you can't get them to deviate from them; they have a place in the new care delivery model.  Are we pushing physicians to be employees, nope.  We will work with them if they are interested, but employment is not for every physician.  We seek common ground for physicians who are looking for a different practice model.  Are we escalating performance expectations, we are for our employed physicians, but at the same time incentivizing them accordingly.

I certainly hope that the many physicians who read this radiologist's blog don't believe what this particular consultant was promoting, but if they do, they need to sit down with a member of the C-Suite with whom they are most comfortable and discuss the contents of the document.

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