Physicians and Organizations: Strange Bedfellows or a Marriage Made in Heaven?

Zuckerman, Howard S.; Hilberman, Diana W; Andersen, Ronald; Burns, Lawton R.; Alexander, Jeffrey A.; Torrens, Paul R.

doi:10.1097/01974520-199801000-00002

Cited by 36 publications

(21 citation statements)

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“…The literature on leadership in medical settings is considerably smaller. Some studies 7,8 have looked at physician executives; a few, 9 at surgical leadership. Researchers agree that physician leadership largely is understudied.…”

Section: Introductionmentioning

confidence: 99%

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Dine¹,

Kahn²,

Abella³

et al. 2011

Journal of Graduate Medical Education

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Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training.

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Section: Introductionmentioning

confidence: 99%

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Dine¹,

Kahn²,

Abella³

et al. 2011

Journal of Graduate Medical Education

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“…1 A flowchart [3,5,7,10,36]. The literature on physician-hospital alignment before 2000 is notably sparse [24,31,55]. These earlier papers address the importance of collaboration, in a general sense.…”

Section: Financial Factorsmentioning

confidence: 99%

“…The financial drivers of alignment noted above have stressed changes in physician practices, challenging physicians to maintain control over their practice environment. Burns and Muller [3], as well as other authors [38,55], note physician control of practices has been eroding and effective alignment models such as joint ventures or service line comanagement offer an opportunity for physicians to participate in decision making and hospital management.…”

Section: Cultural Factorsmentioning

confidence: 99%

“…This supports a conclusion that financial considerations of alignment have emerged coincident with the era of increasing costs of providing care and declining reimbursement. Zuckerman et al [55] wrote the most comprehensive early paper we identified and included reference to a 1995 report (could not be obtained) identifying eight factors that promoted physicians to seek alignment with hospitals in the early 1990s. While mention is made of physician interest in achieving a buffer against health reform/managed care and interest in hospital systems/support services, the authors concluded the factors ''suggest physicians intend to cooperate with and contribute to the organization in some capacities, while retaining a degree of control in others'' [55].…”

Section: Financial Factorsmentioning

confidence: 99%

“…In earlier literature, these factors were also noted. Zuckerman et al [55] cited a 1994 study that included among reasons physicians seek alignment: ''[to] achieve a degree of security. While typically cast in terms of economic security and income stability, lifestyle issues and benefits also are of importance.''…”

Section: Cultural Factorsmentioning

confidence: 99%

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Factors Driving Physician-Hospital Alignment in Orthopaedic Surgery

Page

Butler

Bozic

2013

Clinical Orthopaedics &Amp; Related Research

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Background The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Questions/purposes Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. Methods We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physicianhospital alignment. Literature searches were performed in both MEDLINE 1 and Health Business TM Elite. Results Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Conclusions Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

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Fazit

Amelung¹,

Schumacher²

1999

Managed Care

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Physicians and Organizations: Strange Bedfellows or a Marriage Made in Heaven?

Cited by 36 publications

References 0 publications

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Factors Driving Physician-Hospital Alignment in Orthopaedic Surgery

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