Despite making unprecedented investments in cardiologist integration, hospitals are struggling to effectively leverage the knowledge and expertise of their physicians in growing and managing the CV service line. The lack of a defined growth strategy leaves many cardiologists uncomfortably waffling between the role of clinician and that of administrator, unsure what influence they can or should wield. Private practice physicians are in an even more uncomfortable position, as they also want a voice in service line development discussions but are uncertain of their role. So, what’s the answer? Hospitals need to promote cardiologists to positions of leadership within the CV service line structure. And cardiologists – both employed and private practice – need to proactively pursue leadership opportunities, not wait for them.
Creating a Culture of Physician-Led Governance
Optimal service line decision making cannot occur in administrative bubbles. Programs are finding that promoting a culture of physician-led governance, coupled with strong administrator support, is critical for successful service line development and alignment. Forming a governing body around an inclusive structure gives everyone a seat at the table and allows decisions to be made with the interests and goals of all stakeholders in mind.
And the types of decisions are just as important as involvement in the decision-making process. Governance shouldn’t be an illusion. Physicians accept leadership roles to effect meaningful change, not waste time on inconsequential details. A governing body, then, needs clout within the organization and should have the support of executive leadership to cement importance and maintain accountability for service line performance.
Involving Physicians in Management
In addition to governance, how a service line is managed is tremendously important for its development. Management models for CV service lines are numerous, yet too often default to an administrator-led structure. However, top-performing hospitals have begun to favor the physician-directed or dyad management structures. These models are powerful in elevating the role of the physician, driving alignment, and incentivizing performance. Since many physician recruits are interested in having leadership positions, it also may be easier to attract top physician talent under this model.
While hospitals and physicians ultimately want to do what’s best for patients and the service line, financial interests also must be addressed. Bringing together the interests of cardiologists and the hospital involves expanding opportunities for service line leadership and involvement, and for aligning financial incentives. Building these incentives around quality, efficiency, and the patient experience brings hospitals and physicians together in developing a robust CV service line.
Positioning for Success
Demonstrating a commitment to physicians is essential, as CV services contribute heavily to the profitability for most hospitals and health systems. Those organizations that proactively work to develop and nurture physician leaders will be best positioned for success.
This post is adapted from a column that originally appeared in the May 2014 issue of CardioSource WorldNews, a publication of the American College of Cardiology.