Compensation for elected hospital medical staff leadership

As physicians' practices become more complex and their practice incomes more difficult to maintain, hospitals concurrently require more physician input into organizational, utilization, and strategic planning matters. Physicians and hospitals across the country are discussing the question of financial compensation to physicians for the time they spend performing these hospital administrative tasks. It is already common practice for hospitals to pay a salary for medical direction of hospital departments such as intensive care units or pulmonary laboratories. The question has become whether this practice should be extended to elected medical staff leadership.     

What skills do physician leaders need now and in the future?

The role of the physician leader is moving beyond traditional medical staff issues. A recent national survey of physician leaders shows a growing need for education on specific technical, leadership, and practical skills. The results reveal the medical leadership skills that physician executives consider important today, and provide a window to the future about the skills that will be important tomorrow. Physicians say they need training now in quality assurance, clinical benchmarking, decision-making, and strategic planning. And when they gaze into the future and see the rapid changes throughout health care, they say they'll need more training in communication, organizational change, effective listening, and systems thinking.     

Physician executives: where they are and what they do

As hospital operations become increasingly complex, so does the institution's management and organizational structure. Physician executives with titles of medical director, vice president for medical affairs, medical administrator, chief of staff, medical staff president, etc., are playing more important roles than ever before. This article will briefly review some recent literature describing physician executive profiles. The results from a survey of ten university teaching hospitals are also presented as supplementary information regarding current staffing models. Finally, several physician executive staffing-related issues will be discussed in light of the literature and the survey results.     

Hospital medical directors, quality of care, and financial returns

You are a physician executive working very hard within a hospital on all sorts of medical staff issues and quality of care. You answer to the board. The latter, through its administrators, may still have difficulty documenting the precise value of a full-time physician executive. Your hospital is losing money or not making enough profit for capital expenditures and salary raises. It is considering or will have to consider staff cuts. What can you do that will influence the bottom line, produce a quality image, and quantify your value?     

Boards want leadership and decisiveness.

Regardless of whether they aspire to the top executive spot, physician managers are likely to benefit from insights into what hospital boards want in their chief executive officers. Many of the attributes board chairs desire in hospital CEOs involve how they handle medical staff matters. In general, board chairs want leadership and decisiveness--attributes they likely would covetin any physician manager who has hospital management responsibilities.     

Coaching für die Chefärztin der Chirurgischen Abteilung eines Kreiskrankenhauses

Coaching the head physician of a surgical department The author presents an individual coaching of a female head physician, who is leading the surgical department of a hospital for half a year. The motive were conflicts in the relationship to the colleagues, mainly an interactional conflict with the assistant medical director, caused by dysfunctional patterns of understanding and behaviour. Together with the coach objectives were developed to find a more planning, structuring and communicative leading style. Further more, interventions were prepared and the interactions with the assistant analyzed. Finally, as a first conflict intervention a team discussion is prepared and successfully supported.     

A successful physician referral service.

Developing a successful hospital-based physician referral service can create a win-win-win venture involving the hospital, its medical staff, and the community at large. As a marketing tool for the hospital, it effectively targets two of the hospital's most important markets: physicians and the consumers of health services, the general public.     

Planning in the ministry of industry and tourism

This paper describes the results of the first year of strategic planning in a Provincial Government Ministry. A bottom-up planning process was undertaken, which provided a learning experience for staff, but was time consuming. Results suggest that top-down, goal-orientated, planning is likely to be more cost effective in the future.     

Making a match: inexperienced physician executives and the job market

Hospitals and other health care organizations are adding physician executives at such a rate that demand is outstripping supply-there are more opportunities for seasoned physician executives than there are physicians with track records as medical managers. It is possible that hiring management will have to consider the employment of a physician who wants to be in management but has no track record as a physician executive. In some cases, it may even be preferable to employ a neophyte physician executive, especially when the physician is a respected clinician already on the organization's medical staff. In selecting such a physician, however, an evaluation must be made of the probability that the physician will be successful in the new role. The author points to 10 criteria that the hiring organization should observe in hiring inexperienced managers.     

Re-forming the traditional organization medical staff

The traditional, two-bylaws-model organized medical staff was created in another age (1919) to serve a simple health care system, controlled by physicians, in which the only players were patients, doctors, nurses, and small hospitals. This medical staff model does not meet the needs of the U.S. health care system of the 1990s. The purpose of this article is to provide the physician executive with a resource to use when he or she is called on to help determine what, if any, changes are needed in his or her organization to make the role of physician leaders more effective. Finding the right answer to this question is part of discovering ways to reduce health care costs without reducing the funds available to pay for direct delivery of health care services. Maintaining traditional, bureaucratic, legalistic organized medical staff activities is a very expensive game that we can no longer afford to play.     

Medical staff relations. Creating the nexus.

Bonding of the medical staff to the hospital requires a structured leadership effort on the part of all interested groups. The participants should consist of members of the medical staff, the senior administration, and the board of trustees. The pathways to the bonding process require considerable thought, much planning, frank discussion, and, in many cases, a good deal of time to achieve success.     

The evolution of the VPMA (vice-president, medical affairs)

In the past, the VPMA's role was clearly defined. So were the skills required to do the job. Initially VPMAs served an inside role in an organization as the liaison with the medical staff and the hospital administration. That role has matured and is currently evolving. Ultimately the expansion of the VPMA role will provide alternative career directions for physician executives. The wise physician executive learns from those who have knowledge--or who are in the process of acquiring it. That means keeping an eye on active managed care markets nationwide for trends that may be coming to his or her locale. The physician who does not do this kind of professional introspection and evaluation of the national market may find him- or herself professionally behind the curve.     

Medical staff in need of change. Explore a revolutionary way to reorganize your medical staff.

With demands on hospital medical staffs growing more complex, the days of volunteer or popularly elected medical staff leaders are fading fast. Take a look at the history of medical staff leadership and learn about dramatic changes that could make your medical staff function more smoothly.     

Compensation for chiefs of staff: a '90s phenomenon

As part of its annual survey of physician executive compensation levels, the Physician Executive Management Center, a Tampa, Fla.-based physician executive search firm, sought information on compensation of medical staff leaders. In this report, the Center's findings are summarized. Forty percent of the responding hospitals compensate these leaders in cash, with an additional 34 percent providing noncash benefits. Three-quarters of the hospitals thus indicate recognition that some kind of compensation for voluntary medical staff leaders is warranted.     

Shifting sands for medical staffs

As hospital medical staffs go through major changes, it is time for physician leaders to step up and take on more management roles.     

Environmental scanning for Social Services

This article describes the development of a process of systematic regional environmental scanning as part of strategic planning in the Ministry of Social Services (MSS) in British Columbia, over the 1987-1990 period. Social Services, a large regionalized social service organization, adopted a formal strategic planning process in early 1988. Ministry services are delivered in ten regions with widely varying characteristics. To ensure that this diversity is reflected in the planning process, it is essential that regional environmental information receive consideration. A simple format was developed and regional directors asked to consult with their staff and to scan their regions for issues that may impact the ministry over the medium term. The information obtained was presented by regional directors at a Senior Management Committee meeting and included in the ministry's annual Business Plan, a document which informs staff, contractors, stakeholders, and the community at large of the ministry's values, objectives, and operational goals. The inclusion of regional analyses adds useful information to the Plan. A second output of the planning process is the ministry budget. The systematic regional scans were found to be extremely useful to regional staff, other directors, and to the ministry executives while setting priorities.     

The physician exodus from hospitals

Physicians are spending increasingly less of their work week in the hospital. This is true of surgeons because they are performing more ambulatory surgery, often off the hospital premises, and for primary care physicians because they are delegating hospital care of their patients to others. What are the effects of this physician exodus on hospitals, patients, physicians, and medical education? Some of these consequences are explored, from disruptions in the continuity of care, to increase in practice productivity, to preparing undergraduates for the realities of medical practice.     

Hospital medical director. Documenting roles and responsibilities

Establishing the position of medical director for a hospital entails making a clear exposition of the role of the medical director in relation to the board, the basic administrative structure, and the medical staff. The responsibilities assigned to the medical director in one hospital may differ in more than a minimal manner from those in another institution, and the nature of these relationships may also vary because hospitals differ in their traditions, internal power relationships, and functions. Because of these differences, the need to be precise about roles and responsibilities becomes even more obvious.     

The art and science of starting a new job.

To be successful in a new job out-of-town, physician executives need to develop a plan for a smooth transition into the organization. A checklist to prepare yourself for the new position should include: Updating your research; (2) staying in close contact with your new boss; (3) visiting the office; (4) hiring your own support person; (5) planning the first week; (6) telling the troops how to manage you; (7) making early decisions; and (8) meeting your peers. The focus should be on the job and connecting with your new boss, medical staff, and coworkers--and not exclusively on the environment of your home-to-be.     

Building physician managers and leaders: a model

A needs assessment identified leadership, management, and interpersonal skills as training and development areas for hospital's physician executives. Training sessions were developed and occurred quarterly over a two-year period. Development strategies were designed to enhance transfer of learning from the classroom setting and incorporated personalized coaching sessions, development of a peer mentoring program, group redesign of the performance appraisal process, strategic planning, and performance feedback sessions. The comprehensiveness of the approaches taken in this program is critical to successful training and development efforts of physician executives.