Physician leadership. Physician executives share insights

Senior physician executives were asked to share their insights about how the medical management field has evolved. The Physician Executive Management Center, a Tampa, Florida-based search firm, has been surveying senior physician executives each year for the past decade. This year's report on physician executive compensation and duties in hospitals, managed care organizations, and group practices provides an excellent picture of the growth of the profession, as well as a broad perspective of anticipated changes for the future of medical management. The respondents addressed the following questions: What are the skills necessary for success? How have their jobs changed over the years? Have they made the right choice in pursuing medical management careers?     

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.     

Survey provides overview of profession's responsibilities

At the end of 1990, the Physician Executive Management Center, Tampa, Fla., undertook a survey of College members to determine levels of compensation and benefits and to provide a glimpse at the roles and responsibilities of physician executives. The results of the survey have recently been published by the Management Center. In this article, the roles and responsibilities of physician executives for the overall sample are summarized.     

Quality management remains top medical manager responsibility

Earlier this year, the Physician Executive Management Center conducted a survey of physician executives in management positions in hospitals, group practices, managed care organizations, and industry. Information was obtained for physician executives in both full-time and part-time roles. In addition to gathering compensation information, the survey sought to define the scope and intensity of the responsibilities of physician CEOs and senior medical managers (medical directors or the equivalent) in these organizations. In this article, the authors summarize the findings on responsibilities for senior medical managers in hospitals, group practices, and managed care organizations.     

The compensation of physician executives.

In January of this year, the American Academy of Medical Directors and the Physician Executive Management Center mailed a survey questionnaire to the approximately 2,300 members of the Academy of record at that time. More than 1,000 responses were returned. The purpose of the survey was to begin to collect data and establish a reliable baseline of compensation information for the physician executive profession. Subsequent annual surveys will allow the two organizations to track the course of the profession, insofar as this can be done on the basis of compensation. In this article, we provide a summary of some of the findings of the survey as they relate to physician executives in a variety of nongovernment health care settings. Except for the summary of overall data, the report is limited to the responses of physicians who indicated full-time involvement (75 percent or more) in management. Later this year, the complete findings of the survey will be published in a monograph that will be available from the Academy and Center.     

CEO behavioral pattern expectations for physician executives

This is a report on the second part of a two-stage survey. The first part of the survey, reported in the Nov. 1994 issue of Physician Executive, dealt with physician executive behavior tendencies as viewed from the perspective of physicians, largely in hospitals. In the follow-up portion of the survey, the views of hospital CEOs on this subject were sought. CEOs were also asked for their views on the roles of physician executives and on what they were seeking in physician leaders. CEOs were asked to assess these issues in terms of the ideal physician executive, not the persons currently holding such positions in their organizations. Finally, this second report draws on the results of both parts of the survey in order to make comparisons between the views of the two groups of managers.     

Role stress among physician executives

On the one hand, physician executives are clinicians who place value on professional autonomy. As clinicians, the best interests of the patient drive their decision making and their value system. On the other hand, as managers, physician executives serve as agents of an organization. Because of the differences in the two cultures, some physicians have called the physician executive position a "no man's land" To address these issues and answer the questions that surround them, the authors developed a survey that was mailed to a random sample of the membership of the American College of Physician Executives. Parts of the survey served in other studies of role conflict and role ambiguity. Parts of the survey are new, developed specifically to analyze the physician executive role. The findings are reported in this article.     

Who will lead?

A recent survey conducted by the UCLA Center for Health Services Management and the Physician Executive Practice of Heidrick & Struggles, an executive search firm, sheds light on the emerging physician executive's role. The goal of the research was to identify success factors as a means of evaluating and developing effective industry leaders. Respondents were asked to look at specific skills in relation to nine categories: Communication, leadership, interpersonal skills, self-motivation/management, organizational knowledge, organizational strategy, administrative skills, and thinking. Communication, leadership, and self-motivation/management emerged, in that order, as the three most important success factors for physician executives. An individual's general competencies, work styles, and ability to lead others through organizational restructuring defines his or her appropriateness for managerial positions in the health care industry.     

Physician leaders see eye-to-eye

Late in 1990, the American College of Physician Executives conducted a survey of hospital-based physician executives and chiefs of staff. Each was asked to judge the performance of the other in a wide range of activities. The results show a surprising degree of mutual regard and agreement. The differences, however, are also telling.     

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.     

Present at the creation. Interview by Wesley Curry.

This is the inaugural issue of Physician Executive under the auspices of the new American College of Physician Executives. In this and subsequent issues of the journal, we will feature an interview with a prominent figure in the health care delivery system. We begin with Robert A. Henry, MD, FACPE, President and CEO of SwedishAmerican Corporation, Rockford, III. A Distinguished Fellow of the American College of Physician Executives, Dr. Henry is a Past President of both the American College of Physician Executives and the American Academy of Medical Directors. He currently serves as Chairman of the Board of Directors of the Physician Executive Management Center. Dr. Henry entered medical management in the early days of the profession and is a long-time member of the Academy and College, becoming a member of the former in 1975. He became a member of the College in 1980 and a Fellow in 1981. He became a Distinguished Fellow of the College upon its creation on January 1 of this year. He has followed the growth of the Academy and of the medical management profession for several years and has been an active contributor to the success of both. He is uniquely qualified to discuss both the profession and the professional organization that serves it. The following is a report on a conversation that was conducted with Dr. Henry in early November 1988 while he was in Tampa for a meeting of the Board of Directors of the Physician Executive Management Center.     

Physician executives report high job satisfaction. Summary of findings from a survey of senior physician executives

The role of the senior physician executive is well established in American hospitals and health systems. There is little research, however, on overall physician executive job satisfaction, their perceptions of their organizational role and job performance, or their views of the medical staffs with which they work. A recent survey of physician executives examined these and other areas. It found physician executives to be quite satisfied with their jobs. What follows is a summary of the findings. An article based on the survey will be featured in a future issue of The Physician Executive.     

Hospital size determines department director policy

Early in 1990, the American College of Physician Executives undertook a survey of its hospital-based members to determine the extent to which hospitals had department directors and the roles, responsibilities, and compensation of those directors. The survey form was mailed to about 1,400 College members; responses were received from 734--approximately a 52 percent response rate. This article reports the results of the survey.     

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.     

A behavioral profile of physician executives

In late 1993, ACPE and Tyler & Company, a national health care executive and physician search firm based in Atlanta, Ga., jointly conducted a survey of physician executives to determine their most likely behavioral patterns. It is the first of a two-part survey that, when complete, will create a multifaceted profile of the "ideal" physician executive as seen through physician executives' eyes and through the eyes of hospital management. Questionnaires based on the DiSC method of behavioral analysis were mailed to 750 randomly selected members of ACPE. More than 170 responses were received. The survey results showed that the majority of physician executives have strong communications skills, are people-oriented, and are strong leaders. The majority of respondents are self-motivated and industrious and are driven by accomplishments. The second part of the survey, which will be conducted later this year, will poll hospital CEOs and boards of directors about their preferences for behavioral patterns in their executives. Comparisons and consistencies will be analyzed between the two surveys to develop a comprehensive profile of the "ideal" physician executive, and the results will be reported in Physician Executive.     

No pattern seen in survey for overreader qualifications

A survey was conducted in the fall of 1989 to determine how hospitals handle the task of overreading of computer-generated electrocardiograms. All hospital-based members (1,451) of the American College of Physician Executives were sent questionnaires. Responses were received from 413 physician executives, a response rate of about 28 percent. The results of the survey are summarized in this article.     

Don't be an accidental physician executive

How can physicians begin crafting a career with intention and careful thought? Before you go leafing through The Physician Executive or the New England Journal of Medicine's Positions sections, you'll need to conduct a thorough career evaluation of where you are and where you want to go. There are more career tracks in more types of organizations available to you as a physician executive than ever before. There is also considerable turbulence, creating unexpected opportunities. The times have never been better for aggressive, energetic physician executives who want to move up and out.     

What physician executives and health care organizations should expect from each other

Today, interest in defining the role of the physician executive and ensuring this individual is effectively integrated into the organization is high for good reason--the ranks of physician executives are growing. What attributes should health care organizations look for when hiring physician executives and what should they should expect of them once they are on the job? Physician executives should: (1) have demonstrated clinical and management skills; (2) have a comfort level with participatory decision-making; (3) have superb interpersonal skills; and (4) be a champion of the patient. Physician executives should expect the following support from their organizations: (1) varied roles and responsibilities; (2) mentoring by other senior executives; (3) lifelong learning opportunities; and (4) complete support of the management team.     

Stakeholder strategies for the physician executive.

If physician executives are to be effective in confronting the environmental turbulence and uncertainty facing their organizations, they must effectively manage their stakeholders. This article extends the stakeholder approach described in the May-June 1989 issue of Physician Executive as a tool for the physician executive in the development of practical strategies to cope with turbulence and uncertainty. We suggest four generic strategies physician executives can use: involve supportive stakeholders, monitor marginal stakeholders, defend against nonsupportive stakeholders, and collaborate with mixed-blessing stakeholders. As an overarching strategy, a physician executive should try to change the organization's relationships with a stakeholder from a less favorable category to a more favorable one. The stakeholder can then be managed using the generic strategy most appropriate for the category.     

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.