Physician leadership. How do physician executives view themselves?

Most physician executives today have acquired substantial management training and experience, and many have worked with and relied on the expertise of mentors for their career guidance and development. Physician executives are actually becoming executives who happen to be physicians. They view themselves first as leaders, then as physicians, and finally as managers. That is a remarkable transformation in perception. To chronicle this process, Witt/Kieffer, Ford, Hadelman & Lloyd conducted a national survey this spring among senior physician executives in both payer and provider organizations. The data provide a "snapshot" of their role, and may also suggest some future scenarios for the industry. The primary reasons for choosing to pursue a management role noted by most participants include a desire to be part of the health care solution and an interest in management and leadership challenges.     

Will you be ready when the pink slip arrives?

Are you prepared to ride the waves of change? Will you be ready when the pink slip arrives? Health care executives who can jump a little higher and run a little faster will go further in the draft. Those of you who are prepared for change will always be appealing to recruiters and prospective employers. How can you ride these turbulent waves and not capsize? This article explores some suggestions for positioning yourself: Proper positioning with the inevitable changes in mind will help you move your career in a forward direction.     

Do executives’ aesthetic attributes matter to career and organizational outcomes? A critical review and theoretical integration

How do top executives’ aesthetic attributes, such as their physical (e.g., attractiveness) and vocal (e.g., voice pitch) features, shape their firms and their own careers? Whereas strategic leadership scholars mostly have focused on top executives’ cognitive, psychological, and affective attributes, researchers increasingly have focused on this research question as well. As a result, a substantial body of research has emerged, as evidenced by the sixty-five empirical studies we located. Our review of the literature indicates that aesthetic attributes are related to executives’ careers and organizational outcomes in important ways, including executive selection and firm strategy. There also appear to be important contingencies, such as other individual differences and cultural factors, that shape these relationships. However, we conclude that there are important theoretical and methodological shortcomings in this literature and that addressing these issues is critical to validating extant findings, establishing more legitimacy, and moving this literature forward.     

Opportunities? Barriers? It's up to you.

This career advice column is usually directed toward those in transition--physician executives who are actively pursuing job opportunities or preparing to do so. But most of your career is actually spent in a position and on the job. So it seems appropriate to focus on the great majority of physician executives who are not currently in the job market. Take a look at opportunities to learn and grow in your present position.     

Physician-sponsored networks. Will physicians take back medicine?

Until about the late 1980s, American physicians and their allies, hospitals and the health care manufacturing industries, dominated all facets of the health system--the clinical, the economic, and the political. The bulk of these providers' revenue flowed to them from a highly fragmented insurance system whose governing principle was to provide each insured patient free choice of doctor and hospital. Two distinct, concurrent shifts threaten to erode the medical profession's traditional dominance. The first is a rapid, general shift of control from the supply side of the health sector to its demand side. The second is a shift away from government control, over which organized medicine held much sway in the past, toward private regulators--the executives of the managed care industry. Is the trend towards greater dependence of practicing physicians on non-physician executives inevitable, or can physicians retain--and, in part, regain--their hitherto autonomous position in the health system?     

The next step for physician executives?

The next step for career growth for many physician executives will be the top leadership role in a health care organization. The availability of such positions for physicians has been limited in the past but could very well open in the future. As physicians, administrators, and boards begin to trust each other more and form meaningful partnerships, the potential for physician CEOs increases. In 1997, the Physician Executive Management Center conducted surveys of physicians serving in CEO roles in hospitals and group practices throughout the country. We compared the results with earlier surveys we had conducted since 1986. This article reports the significant findings of these surveys on areas such as employment contracts, job duties, skills and talents, and remuneration.     

Does an attractive partner make you a better leader? Only if you are a male!

We integrate the research on evolutionary leadership with the evolutionary psychology of mate choice to argue that a facially attractive partner signals unobservable leadership qualities of their mate, and thus, partner's attractiveness spills over to their mate's perceived leadership. Study 1 found that while partner's attractiveness enhanced the perceived leadership of male CEOs, female CEOs' leadership was downgraded in the presence of an attractive partner. Study 2 validated that the leadership penalty for female CEOs increased when they were seen with more attractive males than with less attractive males. Study 3 found that conservative candidates that were male benefitted more from an attractive partner than their liberal counterparts but female candidates were penalized regardless of political ideology. Our findings suggest that indirect cues that emanate from the partner are critical for leadership assessment. They invoke attributions that enhance the perceived leadership of males but disapprove of females as leaders.     

Physician-hospital organizations and PHO executives. What lies ahead for the PHO?

The 1996/97 Profile of Physician-Hospital Organizations and PHO Executives, jointly conducted by the American Association of Physician-Hospital Organizations/Integrated Delivery Systems (AAPHO/IDS) and Tyler & Company, takes a closer look at the PHO and trends within the health care system. In examining contracting, enrollees, staff size and experience, compensation, incentives, and projected salary increase for CEOs, the survey found that the PHO is in the midst of transformation into an integrated delivery system. As physicians and hospitals form a team to deliver more efficient and cost-effective health care to patients, they are paving the way to the integrated delivery system. The survey also focuses on the details of the PHO and PHO executives, including an in-depth look at all aspects of compensation for the CEO.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Your direct reports loathe you. Does it matter?

Chalk it up to the labor shortage or to growing worker independence, but today almost everyone agrees that management effectiveness rests heavily on grass roots support. Why do subordinates despise a superior? Indecisiveness, non-support, expense account abuse, and arrogance are some of the documented reasons. Your direct reports can cause you to fail and their perfidy will never be detected. They can question your competence and decisions often-through the grapevine-bombarding top management with derogatory information it ultimately can't or won't ignore. Moreover, the movement of workers from organization to organization means that negative gossip will be repeated in dozens of grapevines. What is the worst thing disgruntled workers do to a manager's career? Not only will victims protest and flack your sins in the grapevine, they'll vote with their feet. Worker shortages mean that turnover is watched as closely as salary expenses. Explored herein are some signs that should cause a manager to examine how he or she stands with the troops.     

Merger mania. What will a merger mean to you?

Almost as worrisome as job tenure to survivors of corporate mergers is whether they will be able to work under a completely new set of assumptions. What effect will the merger of two different corporate cultures have on effectiveness, satisfaction and promotability? Even people who believe they know the partner's culture almost as well as their own are often surprised at what happens after a merger takes place. Find out what's likely to happen in a merger by asking a few key questions.     

Exploring teachers’ career self-management. Considering the roles of organizational career management,occupational self-efficacy,and learning goal orientation.

The current study examines how organizational career management – i.e. activities undertaken by schools in order to plan and manage teachers’ careers – relates to teachers’ career self-management – i.e. teachers steering their careers by means of searching for opportunities, networking, or seeking supervisory support. Moreover, it examines the mediating roles of occupational self-efficacy and learning goal orientation in this relationship. Mediation analysis in SPSS, using the PROCESS macro of survey data from 220 Dutch secondary school teachers, showed that positive relationships between organizational career management and career self-management were mediated by occupational self-efficacy and learning goal orientation.     

Are you obsolete?

Are you vulnerable, regardless of length of service at your organization and your unique skill sets? There are ways to test vulnerability and assemble some hard evidence that your management role makes a difference. You need to conduct a self-test for obsolescence. Ask yourself the following questions: Are your skills state-of-the-art? As a manager, how do you compare with others doing the same, or similar, job at competing organizations? Is your role essential? Where does your job fall into the big picture? Can you be replaced easily? If a thorough examination of your skills and your role convinces you that your contribution returns more to the organization than your salary, can you prove it? Consider these strategies: (1) Put together a portfolio, (2) ensure your boss' support, (3) advertise your successes, and (4) cultivate recruiters. The best reason to analyze your value to the organization is that if you are laid off, getting another comparable job--or a better one--will be far less of a hassle.     

Control exercised by U.S. multinationals over their overseas affiliates: does location make a difference?

Using data collected through personal interviews with senior managers at U.S. multinational headquarters and their U.K., Thai, Malaysian, and Singaporean affiliates, this study examines whether U.S. multinationals adjust the amount of control they use over their culturally different overseas affiliates. Results showed no overall difference in the amount of control that U.S. multinationals exercise over their U.K. and Southeast Asian affiliates. However, differences emerged between these two cultural groups when industry and affiliate top manager type were taken into account. In particular, U.K. locally run affiliates were given significantly more autonomy than their Southeast Asian counterparts. Locally run affiliates in both countries were also given significantly greater autonomy than were expatriate-run ones. Consumer goods affiliates in Southeast Asia enjoyed more autonomy than the industrial affiliates did.     

Which way to the frontier? Physician executives talk about the future

The author interviewed trustees, senior managers, and physicians at Moses Cone Health System in Greensboro, North Carolina, Legacy Health System in Portland, Oregon, and Henry Ford Health System in Detroit, Michigan. These three successful health care systems bracket the national market in size, geography, and managed care penetration. The comments of physicians are presented here, drawn from the book, Designing 21st Century Health Care: Leadership in Hospitals and Healthcare Systems. What emerges most clearly from their comments is the enormity of the task ahead. There is wide-spread agreement that substantial improvements in the quality and cost of care are possible, an encouraging stream of anecdotes and ideas about how to proceed, but a lack of consensus on critical components of how to organize practices and promote effective care.     

Do you demonstrate leadership skills when you speak?

Nervous about your next big presentation? Don't be. There are proven ways to polish your presentation, spice up your speech and capture your audience's attention. Find out how experienced physician executives deliver dynamic presentations and learn tips for avoiding common mistakes.     

Will More Purchasing Options Benefit Customers?

This paper considers the sale of a seasonal product in the face of strategic customers. At the beginning of the selling season, the retailer announces both the price p_h at which the product will be sold during the selling season and the post‐season clearance price p<p_h for unsold items. We analyze two operating regimes: The “no reservation regime” allows a buyer either to purchase the product at price p_h when he arrives or to enter a lottery to purchase at price p if the product remains unsold. The “reservation regime” offers each buyer one extra option than the no reservation regime: reserve the product for purchase at the clearance price p. If the buyer reserves the product under the reservation regime and if it remains unsold at the end of the selling season, then he is obligated to purchase it at price p. We consider a situation in which heterogeneous customers with probabilistic valuation arrive in accord with a Poisson process. We characterize the rational purchasing behavior wherein each arriving customer is strategic; each customer takes other customers' purchasing behavior into consideration. By considering the Nash equilibrium of this game, we show that strategic customer behavior can render the customer to be worse off and the retailer to be better off under the reservation regime, despite the fact that this regime offers one extra option (reservation) to a customer. Hence, more purchasing options do not necessarily benefit customers.