The Time is Now!
Healthcare in the US is in crisis. Many physicians are standing by while the healthcare landscape shifts right in fr0nt of them. Always adept at patient care and focused solely on managing critically ill patients, todays Cardiologists are often ill-prepared for the management of the Medical Business. Most groups (both academic and private practice) are led by physicians over the age of 50. If younger parnters are not suitably trained for leadership, there will be a void of physicians with business management skills and our ablility to practice medicine effectively will certainly suffer. Ultimately, it is the patient that has the most to lose.
What is the Solution?
I belive the answer is the Physician Executive. Today’s physician leaders must not only be exceptional care-givers with supurb clinical skills but be adept at market analysis and spreadsheet interpretation. The days of having an Office Manager take care of all of the non medical concerns of the practice are certainly over. The most successful Physician must now be intimately involved in all business decisions, negotiations with hospitals and insurance providers. Rather than focus on competing with other physicians and physician groups, the Physician Executive must be skilled at compromise–The key to success in negotiations with hospitals, insurers and others is in combining our efforts into a powerful common voice.
What are the risks of the status quo?
At the last ACC meeting in April 2011, it was speculated that within the next 5 years, nearly 90% of all private practices will integrate with hospitals. The private practice model as it has been known for many years will no longer exist and this will certainly have an impact on quality and quantity of care for our patients. Academic centers are not isolated from the “winds of change” either. No two academic centers function alike from a business model perspective. The lack of standardization may result in repeated business related mistakes and no cooperative/unified “voice” to utilize as a lobby for change. As the current leadership continues to age, we must have a generation of Physician leaders to replace them–they must be well equipped to deal with the challenges of rapid change.
Training the Physician Executive
I beleive we have to go to the source of all young Cardiologists–Fellowship. We must begin to include business training within the confines of the Cardiology Fellowship. It should be a component of the ACGME requirements that is just as important as learning how to interpret an Echocardiogram or perform a cardiac catheterization. The training should be practical, yet scientific. The Fellow should be exposed to a combination of didactic lessons provided by MBA school faculty as well as practical rotations through Faculty meetings, board meetings and negotiations with insurance companies and hospitals. The training should expose the Fellow to the challenges of both the academic and private practice economics.
The Time is NOW!
We must take action. Fortunately, some of our leaders are doing just that. Through the development of the Cardiovascular Leadership Institute (CLI), the American College of Cardiology has made the training of Physician Executives a priority going forward. Collaboration with the American College of Physician Executives may yield hybrid training programs where Fellows may also obtain MBA certificates. More importantly, however, Fellows-in-training and newly emerged Cardiologists will have the opportunity to be better prepared for the challenges that medical practice in the next decade will present.