How do physician executives view themselves?
Perhaps the greatest change in the role of the senior physician executives in today's health care provider and payer organizations is the way in which the view themselves. Five years ago, in a national survey, 80 percent reported seeing themselves first as physicians, 13 percent as leaders, and 6 percent as managers. Today, 47 percent view themselves first as leaders, 42 percent as physicians, and 10 percent as managers. That. is a remarkable transformation in perception to have been accomplished in such a short time - a virtual revolution.
The changes run deep. Most physician executives today have acquired substantial management training and experience, and many have worked with and relied on the expertise of physician executive mentors for their career guidance and development. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , we are seeing physician executives actually becoming executives who happen to be physicians. And they see it that way, too.
To chronicle chronicle, official record of events, set down in order of occurrence, important to the people of a nation, state, or city. Almanacs, The Congressional Record in the United States, and the Annual Register in England are chronicles. this process, Witt/Kieffer, Ford, Hadelman & Lloyd conducted a national survey this spring among senior physician executives in both payer and provider organizations who are members of ACPE ACPE Accreditation Council for Pharmacy Education
ACPE American Council on Pharmaceutical Education
ACPE American College of Physician Executives
ACPE Association for Clinical Pastoral Education, Inc. . (The survey yielded a 30 percent response rate, providing career/position data from physician executives in hospitals, health care systems, medical group practices, insurance companies, and managed care organizations throughout the country.) The data provide a "snapshot (1) A saved copy of memory including the contents of all memory bytes, hardware registers and status indicators. It is periodically taken in order to restore the system in the event of failure.
(2) A saved copy of a file before it is updated. " of their role, and may also suggest some future scenarios for the industry.
Increasingly, sophisticated physician managers are undertaking and succeeding in roles for which their medical school backgrounds did not prepare them. These individuals are essentially reinventing themselves through a career change - rising successfully to meet the challenge of health care management, and finding they have a flair for it, even getting a kick out of it, at a time when there may be little reason for joy to be found in many health care executive suites.
The CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. Perspective
In addition, we also conducted a brief companion survey of health care CEOs, asking a few key questions about the physician executive role and giving the CEOs a chance to offer career advice and counsel to them as a group. The results were enlightening en·light·en
tr.v. en·light·ened, en·light·en·ing, en·light·ens
1. To give spiritual or intellectual insight to: and, to a considerable extent, heartening heart·en
tr.v. heart·ened, heart·en·ing, heart·ens
To give strength, courage, or hope to; encourage. See Synonyms at encourage.
Adj. 1. . CEOs overall are pleased with the contributions made by the physician executive role, but they want more. They want physician executives to continue to expand and enhance their management skills, through advanced education and broader experience with the varieties of health care organization styles of operation.
Some findings from the survey deserve a closer look, as they point out positive directions in which the profession is heading, as well as pitfalls that might be avoided.
Provider CEOs told us they actively encourage their physician executives to acquire further formal education: 63 percent of the hospital/system CEOs surveyed claim to pay for or require their physician executives to attend ACPE's Physician in Management programs; 40 percent said they will provide tuition For tuition fees in the United Kingdom, see .
Tuition means instruction, teaching or a fee charged for educational instruction especially at a formal institution of learning or by a private tutor usually in the form of one-to-one tuition. reimbursement Reimbursement
Payment made to someone for out-of-pocket expenses has incurred. for MBA MBA
Master of Business Administration
Noun 1. MBA - a master's degree in business
Master in Business, Master in Business Administration or other master's programs. A smaller percentage said they prefer Harvard-type management short courses for their physician executives, while many said they provide custom-tailored, in-house training. One clearly disgruntled dis·grun·tle
tr.v. dis·grun·tled, dis·grun·tling, dis·grun·tles
To make discontented.
[dis- + gruntle, to grumble (from Middle English gruntelen; see CEO commented: "I would pay for any of it - if they would do it!"
No magic in the MBA
Management degrees may open opportunities for greater success for many physician executives, but the ABA Aba (ä`bä), city (1991 est. pop. 264,000), SE Nigeria. It is an important regional market, a road and rail hub, and a manufacturing center for cement, textiles, pharmaceuticals, processed palm oil, shoes, plastics, soap, and beer. does not possess magical properties. An MBA cannot guarantee spectacular results in the short-term. We hear every week from physician executives who say to us, in effect: "I have just completed my MBA - now, where's the great job with a great salary?" We have to let them down, gently but candidly can·did
1. Free from prejudice; impartial.
2. Characterized by openness and sincerity of expression; unreservedly straightforward: In private, I gave them my candid opinion. . The great job/great salary opportunity will probably come, but often not until executive seasoning has been acquired and honed.
Degrees less common
in provider respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy.
Overall, 18 percent of the physician respondents said they have completed a management degree, while 76 percent said they have taken one or more management courses to develop their skills. Respondents who work for providers are only half as likely to have completed a management degree as those with payers, but there is wide acceptance of educational preparation in other, non-degree-granting forums.
Physician executives with a completed management degree program are, according to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. the survey, more likely to:
* Have been in their organization less
time than the average overall * Have been promoted from within
that organization * Have worked as a physician executive
in at least one other payer or
provider organization * Have had a mentor Mentor, in Greek mythology
Mentor (mĕn`tər, –tôr'), in Greek mythology, friend of Odysseus and tutor of Telemachus. * Have mentored others * Currently not practicing medicine
Those with payer organizations (managed care and insurance companies, in particular) account for the highest percentage of completed degrees, and these organizations report lower base salaries at the middle management level overall than do providers, although payers are far more likely to have incentive award eligibility.
The role of mentors
in career success
Mentors - most often themselves physician executives (74 percent) - play an important role in the success of physician executives. Overall, 42 percent said a mentor has played "a pivotal role" in their executive careers. Those with providers (40 percent) are a little less likely than those in payer organizations (46 percent) to claim the experience of having a mentor. Physician executives say mentors provide them with these benefits:
* Awareness of educational
opportunities and career
* An example/model of executive
behavior and leadership
* Direction/guidance at decision
* Development through personal/
Average salaries - but who's average?
The average salary of all the physician executives participating in the survey was $172,000. In providers, the average ($183,000) is considerably higher than the average in payers ($153,000). It should be stressed that these are average amounts; replacement costs for a physician executive would be far higher. CEOs often experience "sticker shock Sticker shock is a United States term for the feeling of surprise experienced by consumers upon finding unexpectedly high prices on the price tags (stickers) of products they are considering purchasing. " when their physician executive must be replaced. In addition, exceptional performers will earn far more than average. The survey allowed us to analyze base salary data by a number of factors to define average salaries for physician executives - by tenure and promotion history, by work and mentoring experience, and by whether currently in medical practice, as well as by organization types.
1. Unselfish concern for the welfare of others; selflessness.
2. Zoology Instinctive cooperative behavior that is detrimental to the individual but contributes to the survival of the species. motivations
The primary reasons for choosing to pursue a management role noted by most participants are proactive, positive, and optimistic op·ti·mist
1. One who usually expects a favorable outcome.
2. A believer in philosophical optimism.
op . Response were about the same for both provider and payer groups. They include:
* Desire to be part of the health care solution (45 percent) * An interest in management and leadership challenges (37
percent) * Other reasons - post-retirement opportunity, curtailment Curtailment
The act of contracting or reducing operations of a company in the hope of bringing it financial or operational stability. This management technique is often used when a company has grown too fast and is unable to effectively manage its operations. of
medical career by physical or health disabilities, better hours,
predictable schedule, higher income, practice frustrations,
loss of interest in medical challenges (18 percent).
Aspirations aspirations npl → aspiraciones fpl (= ambition); ambición f
aspirations npl (= hopes, ambition) → aspirations fpl for the future
Although they appear to be even better prepared to assume the reins reins
The kidneys, loins, or lower back. of leadership than in the past, only 27 percent of respondents overall said their "ideal professional role" in five years would be CEO or President of a health system, hospital, managed care company, or medical group practice. In a similar survey by the firm two years ago, almost all of the physician executive respondents reported aspiring as·pire
intr.v. as·pired, as·pir·ing, as·pires
1. To have a great ambition or ultimate goal; desire strongly: aspired to stardom.
2. to a CEO role. Most (40 percent) envision themselves in a senior management role, but not the top spot. Another 15 percent said they would like to be right where they are now, and 10 percent said they would be cutting back or retired. The remainder were not sure or expect to leave the health care field for another area.
Interestingly, there is not notable rush to relocate re·lo·cate
v. re·lo·cat·ed, re·lo·cat·ing, re·lo·cates
To move to or establish in a new place: relocated the business.
v.intr. in the other's venue; neither provides nor payers indicated any strong expectation of movement over to the other's environment in the coming years. The distinct physician executive profiles that have begun to emerge from those in payers and in providers will be interesting to track. At some point, will "crossovers" be plausible?
What does it all add up to? The bottom lines...
* Physician executives in payer and provider organizations
may have similar titles but they are developing very different
profiles - not only in what they do and earn, but in
how they perceive the health care field. Payer-based physician
executives look more business-like; they are more
likely to have business degrees; and to have more income
* A revolution is stirring. Many physician executives are in
truth becoming executives who happen to be physicians - they
view themselves first as leaders, then as physicians.
Along with their personal perceptions, a decline in the numbers
of those who maintain a medical practice reinforces the depth of that professional shift.
* CEOs are actively encouraging their physician executives to acquire more formal education. Physician executives are pursuing both degree and non-degree programs. A management degree, however, does not give instant entree to the best jobs.
* Obviously, merely having a mentor will not ensure the physician executive's success; one must heed the mentor's advice and act on the mentor's guidance for the experience to be meaningful. Interestingly, being a mentor also has a favorable fa·vor·a·ble
1. Advantageous; helpful: favorable winds.
2. Encouraging; propitious: a favorable diagnosis.
3. influence on success.
* Highest salaries are paid to senior physician executives in hospitals and systems, particularly to those who have been promoted through the ranks, those who have had a mentor and who have, in turn, mentored others. Although average salaries are lower in payer organizations, 88 percent are eligible for incentive awards; only 52 percent of those in provider organizations are eligible for incentives.
TABLE I PURSUIT OF FORMAL MANAGEMENT TRAINING Training Total resps. Payers Providers Management 76% 69% 80% courses Management 18% 26% 13% degree Other 18% 14% 20% TABLE 2 AVERAGE SALARY RELATED TO MANAGEMENT DEGREE $150,000 or less $151,000- $200,000+ $199,000 Providers with 33% 33% 34% management degree Payers with 43% 20% 37% management degree
1. Having a plane surface; flat.
2. Organized as a table or list.
3. Calculated by means of a table.
resembling a table. DATA OMITTED]
The authors are all physician executive search consultants with Witt/Kieffer, Ford, Hadelman & Lloyd, an executive search firm serving the health care industry founded in 1969.