Council Connection: Physicians as Co-managers

John Commins, for HealthLeaders Media , September 28, 2011
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Cliff Deveny, MD
Senior Vice President for
Physician Practice
Management, Catholic
Health Initiatives, Denver 

Transparency and accountability: If the physicians are seeing everything, then there is accountability. Once physicians are held accountable they tend to be very competitive and don’t want to be the poor            performer. When you rank people and put it out there, they react to that.

There is historically a culture of distrust that comes from a lack of transparency, a lack of understanding of each other’s perspectives. In most hospital systems the physicians have never been given the data in a way that allows them to be held accountable.

Creating alignment: Depending on the market and the situation, I find that clinical comanagement works well, sometimes as a subset of a joint venture. In joint ventures, we would give the management of the joint venture option to the physicians and we would find that they did a good job with driving down costs and improving satisfaction. There was an extra incentive as managers. In the models where there is just clinical comanagement, it works with a sophisticated group of physicians who are integrated and willing to work together as a team. When you have a fragmented medical staff or group of individuals, it is harder to drive that because you have to create some kind of legal structure.

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Creating incentives: Comanagement can work with employed physicians because you could put incentives in their compensation schedule that are more around group productivity or performance bonuses, not unlike what you see with senior management folks in the hospitals and systems, in that we have base pay and bonuses based on certain metrics. You could create that same sort of infrastructure for physicians.
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