ABSTRACT
The Leading Beyond the Bottom Line article series has received an overwhelming response from ACPE members, mostly in enthusiastic support of this new leadership concept. Some of the important questions raised by members are presented with answers from the authors. This article also explores the moral challenge of leadership and why health care is more than a business. In recent years, there's been confusion about the role of the health care enterprise, its leadership and its management. We have lost our way about the "moral" thing, the "right" thing, because we have no philosophy to guide us. To manage or lead in this "business" of health care, a philosophy is required that recognizes the multiple elements to which the leader has responsibility and obligations: the customers, community, employees, and, certainly, the financial assets.
Subject(s)
Delivery of Health Care/organization & administration , Leadership , Organizational Culture , Physician Executives , Community-Institutional Relations , Delivery of Health Care/standards , Ethics, Professional , Humans , Morals , Physician-Patient Relations , United StatesABSTRACT
Do physician executives approach managing and leading health care organizations like a CEO of a Fortune 100 company? Or does their training as physicians first give them a unique perspective, leading them to view organizational issues differently? The authors suggest that to be a physician executive is to be the practitioner, teacher, coach, and mentor for a new philosophy of leadership and management called Leading Beyond the Bottom Line. While the financial health of an organization is critical to its survival and its ability to fulfill its purpose, the trap is to focus on maximizing the bottom line. This new philosophy leads an organization to attend in equal measure to the (1) welfare of its patients, (2) its financial health, (3) the well-being of its employees, and (4) the building of its community. "The Optimal Organization" is one in which these four objectives are seen not only as related, but interconnected, and the goal is to maximize all of them. The legitimate role of the physician executive is to manage in search of Pareto Optimum, or the maximum benefit for all four organizational objectives. Clearly, this is a tougher job than maximizing profits or just optimizing profits and patient care.
Subject(s)
Health Services Administration , Leadership , Physician Executives , Decision Making, Organizational , Efficiency, Organizational , Humans , Organizational Culture , Organizational Objectives , Physician's Role , United StatesABSTRACT
Organizations are created to aggregate resources to accomplish some purpose, be it to provide health care, raise a family, or build cars. These resources are assets. A manager has a fiduciary responsibility, by practice, and, in many cases, by law, to make the best use of those assets. Traditionally, we've evaluated the use of assets through financial statements. The troublesome aspect of these financial statements is that they were designed to measure only those things that can be counted simply--financial and physical assets. But our world has moved from an industrial, manufacturing age to an information, service economy and we are learning that intangible assets are as powerful--potentially more powerful--in creating value as are tangible assets. Recognizing the intangible asset value of employees, customers, and the community is the challenge in this new service economy. Effective health care leaders need to leverage and manage all of an organization's assets.
Subject(s)
Delivery of Health Care/organization & administration , Leadership , Physician Executives , Consumer Behavior , Organizational Culture , Personnel Management , United StatesABSTRACT
How do you transition from physician executive to physician CEO? Three physician CEOs were interviewed to explore the skills they needed to land in the top position. They share their views on what it takes to be a successful CEO. They describe the skills that they needed when they moved into the CEO role and how they acquired them. Some of the qualities it takes to be a CEO include the ability to: Articulate your values; use your people skills; describe a vision; solve problems; listen; walk around; and use analytical skills.
Subject(s)
Physician Executives , Professional Competence , Career Mobility , Chief Executive Officers, Hospital , Communication , Humans , Interpersonal Relations , Interprofessional Relations , Personnel Management/methods , Problem Solving , United StatesABSTRACT
Physician issues are at the heart of today's debate on how to reconfigure the delivery and financing system. Leaders agree that you can't live without doctors, but it can be difficult to live with them. In this fourth and final CEO Summit series planned by McMannis Associates and cosponsored by Hospitals & Health Networks, CEO leaders dissect some of the trickier physician issues.
Subject(s)
Decision Making, Organizational , Governing Board/organization & administration , Hospital-Physician Relations , Hospitals, Proprietary , Hospitals, Voluntary , Leadership , United StatesABSTRACT
There's a flood of change coming, and health care executives are quickly building and loading big boats to sail to the future. But what do you take--and what do you leave behind? What will be needed in the new world--and what won't? In the third of an exclusive four-part series planned by McManis Associates and co-sponsored by Hospitals & Health Networks, some top CEOs talk about their travel plans.
Subject(s)
Community Networks/organization & administration , Hospital-Physician Joint Ventures/organization & administration , Decision Making, Organizational , Economic Competition , Medicine , Specialization , United StatesABSTRACT
A new breed is evolving in health care. A provider sponsored network i s part insurance function and part provider function. But no one knows exactly how it will behave. In the second entry of the exclusive four-part CEO Summit series planned by McManis Associates and cosponsored by H&HN, some top leaders in health care discuss some of the conflict in this changing delivery system.
Subject(s)
Community Networks/trends , Insurance, Health/trends , Conflict of Interest , Hospital-Physician Joint Ventures/trends , Physician's Role , Quality of Health Care , United StatesABSTRACT
BACKGROUND: Public accountability is the watchword of the 1990s. A chief executive officer (CEO) has many "publics," internal and external, demanding accountability. Most have different agendas. Although much rhetoric is focused on quality, access and cost seem to be the real interests of most constituents. ISSUES: What tools help the CEO respond effectively in this environment? How useful will outcome measures be to the CEO in the current competitive environment? If outcome measures are not useful in gaining market share, do they have other value? What other means are available for the CEO to learn about the quality of care in their institution? In addition to quality, what other issues should be of primary concern? CONCLUSION: Quality care, as measured by outcomes and other means, is a necessary but not sufficient condition for success in the current environment. Market share is still largely determined on the basis of price. A basic commitment to quality is still paramount. The CEO also needs to focus on value, defined as quality/cost x efficacy (appropriateness) in dealing with constituent groups. Other components of success include developing a clear vision for the institution and finding appropriate partners. Public accountability presents a challenge and an opportunity for CEOs to demonstrate commitment to meeting the hospital's obligations.
Subject(s)
Hospital Administration/standards , Hospital Administrators/standards , Social Responsibility , Total Quality Management/organization & administration , Forecasting , Hospital Administration/methods , Hospital-Physician Relations , Humans , Interinstitutional Relations , Total Quality Management/economicsSubject(s)
Hospital Departments/organization & administration , Hospitals, Teaching/organization & administration , Budgets , Cost Allocation , Diagnosis-Related Groups , Hospital Bed Capacity, 500 and over , Humans , Management Information Systems , Maryland , Nursing Service, Hospital/organization & administration , Personnel Management/methods , Physician ExecutivesABSTRACT
The survival of transfused platelets is inversely related to the time of storage of platelets in vitro. The effects of storage on the ability of platelets to produce retraction of clots and on the morphologic alterations of platelets within the clots has been studied. The results suggest that clot retraction, using low concentrations of platelets, may be useful as an in vitro method for evaluating the viability of platelets.
