Healthcare leaders need to reinvent the C-suite and establish a new set of leadership skills to help them address the challenging nature of hospital-physician competition and collaboration. These new management core competencies or the "seven Cs" are:
Two weeks ago, we explored the first three core competencies of the seven Cs. This week, we continue with competencies four through seven.
Physician-hospital competition is a nationwide issue that affects how hospitals and physicians relate to one another. Without a clear basis on which to proceed, your organization will flounder and shudder in the face of unmanaged competition. The following are strategies and tools to employ in this potentially volatile arena.
For instance, a solid conflict-of-interest policy that encourages full disclosure goes a long way in helping medical staffs and hospitals achieve the goal of figuring out how to collaborate and compete. A good starting point is to understand the myriad ways in which conflicts of interest can occur. Some of these include:
Physician group conflict:
Physician's personal conflict:
In recent years, hospitals have developed various strategies for handling competition from physicians. Some have pursued joint ventures for ambulatory services or opted to build service lines to try to force competitors out of the marketplace. Hospitals that pursue these options often deny medical staff membership to physicians with competing interests. Other hospitals prohibit physicians with competing interests from serving in leadership capacities. This is generally addressed in an economic credentialing policy adopted by the board.
The way an organization handles conflict is often determined by its culture. Some cultures view every conflict as an opportunity to crush the competition through belligerence and bullying. Others are characterized by thoughtful responsiveness, sensitive to the feelings and concerns of others. A good starting point is to know your organization's style and then objectively analyze whether the strategic results are what you wish them to be.
Many organizations have little self-knowledge or recognition of their style. If we accept that conflict is a huge growth line in contemporary healthcare, then best practice is to design and implement a conflict management system.
In their book Designing Conflict Management Systems, Cathy A. Costantino and Christina Sickles Merchant state that there is a spectrum of alternative dispute resolution options that range from least invasive (those that allow disputants the most control over the process and outcome, such as negotiation) to most invasive (those that allow disputants the least control over the process and outcome, such as binding arbitration). What might such a progressive system look like for a medical staff and hospital?
Elements to consider, in ascending order of invasiveness, are: