Yet he did face some resistance.
"What I heard is that 'If it's working for me, why do we want to change it?' " he says of discussions with fellow physicians who were hesitant to give up some control in managing their APPs. "I just had conversations with them and we agreed that in the long run it's advantageous to all of us because healthcare is more and more of a team sport."
The other thing to realize if you are considering a similar management change, says Leonard, is that not everything is contained in policy, explaining further that he makes the case with his physicians that the change is not an attempt to "control the world, only some parameters and consistency," he says.
The access issue is even more compelling. "We're preparing for bringing a large group of people into our system as patients and as providers, and if you don't have established direction and culture, [then] you have more chaos than you expect to have."
Above all, he says, communication—in some cases overcommunication—is the best approach when implementing such a big change, no matter whether it's in compensation, management of APPs, or integrating a merger.
"The most difficult thing for CEOs is that your good intentions aren't always clear in this kind of project," he says. "Be consistent and really transparent about what you're trying to do. The APP people are undergoing tremendous change in expectations in healthcare. Roles, scope of practice, compensation, and benefits are all on a wild ride, so you have to recognize that in the middle of such change, that is disconcerting to a lot of people."
This article appears in the September issue of HealthLeaders magazine.