Physician executives boost clout, earning power.

Results of the 2001 Physician Executive Compensation Survey are in and they show that physician executives working in practice/hospital management companies or single specialty groups earn the highest pay. Physician executives with advanced degrees appear to earn more, as well.     

The physician executive "arrives"--a new generation prepares for the future

The recent rise in the number of physician executives in the health care industry vividly demonstrates that a genuinely new generation of physician executives is seeking to combine the sensitivity of their clinical skills with the business acumen that today's health care organizations need to prosper and grow. But physicians who are preparing themselves to be selected one day as chief executive officers by hospitals, integrated systems, and managed care organizations should understand that the CEO role is radically different from that of the CEO of a physician practice. The corporate CEO role requires the management of managers and responsiveness to the organization's board. Those who imagine that the corporate CEO role bears any resemblance to the autonomous, independent existence of the practitioner are certain to have a rough time.     

How practicing physicians are adjusting to managed care

Managed care is here to stay. In fact, for the foreseeable future, health care will become increasingly more managed each year. The purpose of this article is to help physician leaders and executives understand how clinicians are reacting and adjusting to managed care. Those of us who are doing primarily management activities have our own set of problems and adjustments. Sometimes we can be insensitive to the problems that physicians who are primarily treating patients can have as a result of managed care. Health care executives who are managing physicians or attempting to influence their behavior must attempt to understand clinicians' feelings, reactions, and coping mechanisms.     

Care management challenge is the toughest yet.

The newest health care trend involves changing the core business--health care delivery and the resources involved--through better care management. This impacts every practitioner all day, every day. This issue truly belongs to the physicians, and thus to physician executives. Care management is the latest frontier, the place where the delivery of quality care, in the most efficient way, at the best possible cost, all come together. And physician executives are being challenged to make it happen, to change the way medicine is practiced and health care is delivered across the country, to move from treating episodes of care to a true preventive mindset and population-based methodologies. This column outlines the skills in care management that systems-based physician executives will need to develop or enhance to remain competitive--effective communication skills and team-building capabilities are critical attributes for those who hope for success.     

Wanted--seasoned veterans. Diamonds in the rough need not apply

Health care organizations looking for physician executives prefer seasoned veterans--doctors who have already done the job. They want job-specific experience. Most organizations do not provide training grounds and orderly career ladders for aspiring physician executives. The Permanente Medical Groups, Family Health Plans, and some very large group practices are exceptions, but, for the most part, rising medical directors in these organizations stay with them. Most hospitals are not large enough to have associate or assistant medical directors or an environment that could provide a training ground for rising physician executives. On the other hand, hospitals, larger group practices, health insurance companies, and managed care organizations provide ample opportunities for nonphysician managers to train, gain experience, and climb the ladders. How can the novice physician executive break into the world of management and begin establishing management credentials? The author provides some key steps that can lead to success.     

The future of health care, Part 2. The PPMC debate. Panel discussion

In Part 2 of this second annual panel discussion, Jeff Goldsmith, Barbara LeTourneau, Uwe Reinhardt, and physician executives from three physician practice management companies (PPMCs) examine this burgeoning new industry. They grapple with questions (and occasionally with each other), such as: Are PPMCs delivering what they promise? What will separate successful PPMCs from the rest? When PPMCs win, who loses? What value do PPMCs add to health care? What lies ahead for this industry? Could Wall Street pressure cause PPMCs to put profit ahead of physicians and patients? And, what roles will physician executives play in PPMCs?     

Health care futures, Part 1. The emergence of the new health care consumer. Panel discussion

In Part 1 of this second annual panel discussion, six experts examine the new health care consumer. The whole concept of the patient as consumer still makes people uneasy when it's applied to health care. Whether you prefer consumer, customer, purchaser, end-user, ultimate buyer, or beneficiary, one thing's for sure: Many of us are as different from the bygone patient as an HMO is from the general practitioner who made house calls. One of the reasons for many Americans' new interest, knowledge, attitudes, and expectations about health and health care is the Internet, the second topic in this discussion. In Part 2, physician executives from the three leading physician practice management companies (PPMCs) join Jeff Goldsmith, Barbara LeTourneau, and Uwe Reinhardt for a spirited exchange about this burgeoning new industry in the American health care sector. They will tackle questions such as: Are PPMCs delivering what they promise? What will separate successful PPMCs from the rest? Can PPMCs meet Wall Street's earnings expectations and also help physicians deliver better care? When PPMCs win, who loses? And, what roles will physician executives play in PPMCs?     

Coaching im Rahmen von Bedrohungsmanagement

Threat management is a young discipline in practice as well as theory. Coaching of executives shows a new, specific intervention form in this context. For this matter it requires a high professional knowledge which allows an expert’s consultation and a professional process consultation, to do justice to process-like threatening events or to the adequate contact. The present contribution reflects the complicated connections of male executives in particular with the focus on emotion regularisation and action optimisation.     

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.     

Behavioral quality assurance: a transforming experience

The captains of the health care industry are leading a transformation in health care. Increasing numbers of physician executives are acquiring the knowledge, skills, and attitudes essential to both the science and the art of management. If they wish to practice the art of management at a high professional level, however, physician executives must be willing to experiment with their behavior in interactions. Change and growth in this aspect of human nature will also bring them face-to-face with their self-images. More important, attention throughout an organization to behavior toward one another will have a significant bearing on the quality of the organization's services to clients.     

How are Methodologies and Tools Framing Managers' Strategizing Practice in Competitive Strategy Development?

Criticisms have been levelled at the use of traditional strategic tools such as SWOT, PEST and BCG in contemporary business environments. In light of these criticisms, the objective of this research is to understand how senior executives engage with methodologies and tools as they develop competitive strategy. Within a broader strategy‐as‐practice approach, we use an activity theory framework to capture strategizing insights of senior executives in the UK responsible for competitive strategy. Our sample includes executives leading manufacturing organizations embedded in networks and CEOs reported in the financial press as adopting innovative business models. Our data suggest there is no one preferred practice approach by these highly regarded executives. Rather, methods and tools are adapted as they are contextualized in alternative practices. Three dominant strategizing practice models emerged from the data reflecting alternative applications of methodologies and tools. The first model captures routinized behaviour adopted by those who view their future as predictable, and an extension of the current environment. The second model posits reflective interaction between the strategist, organizational processes, culture, relationships and practice, and the final model shows an imposed engagement with strategizing methodologies and tools that bypass the organization's collective structures. These practice models suggest strategy leaders' activities depend upon their interpretation of the operating environment.     

Physician executives' characteristics and attitudes

This monograph reports on a survey of physician executives who are members of the American College of Physician Executives. The survey emphasized four areas--factors in an individual's move into management as a career choice; satisfaction with management as a career or as an element of a career; factors that prepare a physician to manage; and factors in future development of physician managers.     

Why an MBA?

As physicians move into medical management, leaving clinical practice behind to play a major role in managing physician performance and clinical processes, they are having to deal in the business world. Physician executives are donning the pinstripe suit instead of the white coat, and adding a business acumen to their clinical skills. Many have opted to pursue executive MBA programs to learn the business competencies they need to manage health care organizations. This article summarizes the educational opportunities available in executive MBA programs and discusses the value of business training for aspiring physician executives.     

Managers as Monitors: An Analysis of the Non‐executive Role of Senior Executives in UK Companies

An important aspect of current governance practice is the use of non‐executive directors to monitor the behaviour of company management. This paper examines the extent to which senior executives are utilized as non‐executives in large UK companies. The results suggest that executive directors are not an important source of non‐executive directors. The average number of non‐executive directorships held by each executive is 0.22. Indeed, 85% of executives hold no additional directorships. The holding of non‐executive directorships is positively related to the strength of board monitoring in the executive's company, executive tenure and company size. Executives in companies with greater growth opportunities and operating in regulated industries are less likely to hold non‐executive directorships.     

Physician executives in the 21st century: new realities, roles, and responsibilities

This article is based in part on responses from 150 physician executives who participated in an interactive discussion of future trends at the American College of Physician Executives' 1999 Spring Institute and Senior Executive Focus, in Las Vegas, Nevada, on May 13, 1999. The session included electronic polling on 40 predictions, such as the future composition of the clinical workforce and how technology will affect the way that medicine is practiced and the patient-physician relationship. The prediction for physician executives? A growing number of physician executives will find themselves at the top of their careers in the next decade. The physician executive of the future will have a broad array of management opportunities and career choices. More doctors will be managers. Physician executives will work at every level of health care organizations, across the continuum of care, from large complex urban systems to small rural settings.     

Between jobs: the search for a management position

Being out of work for physicians traditionally has meant that period after a severe illness or disability and before resumption of practice. As physician executives, we should think of the unthinkable. It also can mean being unemployed. That possibility is quite real, and yet we are ill-prepared to handle it. By inference from the national unemployment rate, there may be 200-300 members of the College who are "between jobs" at any given time.     

Physician executives: managers first, clinicians second

The literature is replete, many would say depressingly so, with accounts of the changes that are rocking the health care delivery system. The demands on the system's leadership increases with every change. And the future holds even more changes, with a level of uncertainty that will makes today's demands seem childplay. Physicians, especially physician executives, will surely be key factors in helping the system maintain its fundamental charge of high-quality patient care provided at reasonable cost, but what exactly is expected of them? One point is clear: While their clinical backgrounds will continue to arm them well for reaching the executive suites of health care organizations, physicians who hope to fully succeed in management will have to acquire and master a widening range of management skills. An indication of just how demanding the health care management job will be is provided in this report, based on interviews with physician executives and the people who seek and sell their services.     

Integrating computers and marketing management: A European overview

The authors look at the role of computers in marketing management, examining some current literature on computers and marketing decision support systems (MDSS). They then present the results of a survey to gauge the extent to which computers are being used by marketing management in Europe, and explore the potential for accelerating the process of integrating computer technology into the marketing manager's job. Specifically they examine the current personal computers (PCs) usage patterns of 50 marketing executives in a selection of high-performing industrial corporations in Europe.The article then briefly highlights areas of greatest PC applications by these executives and the benefits they have brought in practice. It also identifies the problems they have experienced and their views on how better and more effective utilization can be made of the technology in order to enhance their managerial capabilities.     

The physician's alternative career transition model: a stepwise approach

The recent intense focus on marketplace reform has stimulated a reassessment of career planning options for some physicians. These socioeconomic changes have created unique opportunities beyond the traditional arenas of clinical practice and medical management for physicians to leverage their medical degrees and experiences in the business world. This paper presents three case reports of physician executives who have successfully pursued medically related business career options, each following different motivations at various stages of their medical careers. It then discusses the Physicians' Alternative Career Transition (PACT) model developed by the authors to assist other physicians who are considering making transitions into business-related careers. The PACT model is based on four critical steps for practicing physicians to make these transitions successfully: an internal self-evaluation process, an external environmental evaluation process, seeking the best "career match," and securing the career match.     

Does disease management work?

Is disease management the "solution of the month" or a valid approach to organizing patient care? In the era of rapid change in health care, disease management is emerging as one technique suited to improving measurable health care outcomes at greater cost effectiveness. By taking a leading role in the process, those physician executives who commit to this approach can greatly enhance the potential of these programs to accomplish the desired results.