Muller says within primary care, she's seen physicians go through the emerging leadership class go on to become medical directors.
"I can see the growth in how they lead, as their supervisor," says Muller. "The number of people I'm getting notified about getting nominated to [this class] is also increasing. In our system all of our physician leaders are paired with an administrator and interactions are much more fruitful and constructive. I can see culture changing."
The third level of classes is the deepest dive, called Leadership Foundations. It's a two-and-a-half day program, and the participants have to be in a formal leadership position at Legacy Health. This is the class where physicians leadership skills are put to the test, says Muller.
"One of our leaders who just went through the Foundations course is responsible for surgical site infections, and was struggling to push things to the next level," says Muller. "He felt that the skills he learned helped him look at the problem differently. He looked at the process of patient flow and staff… made changes in both, which increased throughput. We've seen an improvement in quality. Is it all physician leadership? No, but it is part of it."
Muller and Goren both use anecdotes from physicians who attend the leadership academy to show improvement. It's difficult to empirically tie outputs to the soft, but important skill of physician leadership. A 2011 study attempted to show the relationship, but the quality indicators the study relied on were U.S. News & World Report rankings, which are not widely accepted as healthcare industry standard for quality.