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
Leland Kaiser, PhD, a long-time member of the ACPE faculty, describes opportunities in terms of surfers. Many smaller and insignificant waves will appear before the surfer senses "the big one." The knowledgeable and skilled surfer will distinguish these small waves (mere fads in management terms) from the real one (a significant trend for the medical manager). If the surfer catches the big wave before its crest, there is a formidable danger of being too far in front and being crushed by it. If the surfer misjudges the wave and starts behind the crest, the wave will leave the surfer behind. It is only by catching the wave at or near its crest that the surfer has a chance for a long and exciting ride. And, of course, even having judged the wave perfectly, there is no guarantee of success. The surfer must still use his or her skills with daring and precision if the ride is to end in the calmer waters of the shore and not in the toss and tumble of a spill.
