Physician executives share insights.What do physician executives see as the skills necessary for success? How have their jobs changed over the years Have the made the right choice in pursuing medical management careers. The Physician Executive Management Center, a Tampa Tampa (tăm`pə), city (1990 pop. 280,015), seat of Hillsborough co., W Fla., a port of entry with an impressive harbor on Tampa Bay; inc. 1855. , Florida-based search firm, recently surveyed physician executives in hospitals, managed care organizations, and group practices and their responses provide an excellent picture of the growth of the profession, as well as a broad perspective of anticipated changes for the future of medical management.
Skills needed to succeed
Physician managers are being asked to bridge the gap between administration and the medical staff. Often, it is the physician leader, in the organization who acts as the "messenger" for each side. The ability to see the "big picture" and move others in that direction is critical.
Skills cited as necessary for success in management listed in rank order are:
* Effective communicator
* The ability to persuade TO PERSUADE, PERSUADING. To persuade is to induce to act: persuading is inducing others to act. Inst. 4, 6, 23; Dig. 11, 3, 1, 5.
2. In the act of the legislature which declared that "if any person or persons knowingly and willingly shall aid or assist any , motivate,
or influence others
* Effective written communication,
* Strategic planning Strategic planning is an organization's process of defining its strategy, or direction, and making decisions on allocating its resources to pursue this strategy, including its capital and people.
Changes over the past decade
Physicians were asked to what degree their current positions have changed over the years, the Years, The
the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109]
See : Time manner in which the change occurred, and what they thought were the reasons. Hospital physician executives indicated that changes in their roles began with the onset on·set
A beginning; a start, as of a cold. of managed care and system integration, plus their need to assume system responsibilities. Managed care physician executives suggested that changes in their roles happened as a result of reorganization The process of carrying out, through agreements and legal proceedings, a business plan for winding up the affairs of, or foreclosing a mortgage upon, the property of a corporation that has become insolvent. , adding a broader scope of duties and expanding geographic regions. In groups, where the highest percentage of change was reported, complexity, increased managed care, and expanded duties were cited as reasons.
Eighty-seven percent of physicians serving in senior management positions have no clinical responsibilities. This is a dramatic change from 10 years ago, when half of these managers had clinical duties. The concept of physician executives continuing to do some hands-on hands-on
Involving active participation; applied, as opposed to theoretical: "We're involved in hands-on operations, pulling levers, pushing buttons" Arthur R. Taylor. clinical work as a means of establishing credibility Believability. The major legal application of the term credibility relates to the testimony of a witness or party during a trial. Testimony must be both competent and credible if it is to be accepted by the trier of fact as proof of an issue being litigated. is fading fading
fading skin coloring. See Arabian fading syndrome (below). Declining in body condition, general health, activity and productivity.
Arabian fading syndrome
general health is unimpaired. .
Physicians were asked if they were satisfied with their career choice. More than 99 percent of 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. in each category indicated the were glad they had made a career move into management. Not only do they feel it was a good move for them, they would recommend it to colleagues.
When asked what they have learned over the years, physician executives indicated the art of patience Patience, poem
Patience: see Pearl, The.
patience, card game
patience: see solitaire.
See also Longsuffering. in making a career change physicians have had to learn to deal with large corporate structures where decisions require teamwork (product, software, tool) Teamwork - A SASD tool from Sterling Software, formerly CADRE Technologies, which supports the Shlaer/Mellor Object-Oriented method and the Yourdon-DeMarco, Hatley-Pirbhai, Constantine and Buhr notations. and consensus. They have found that is it no longer a physician-controlled environment, as in clinical practice where decisions might be made quickly and autocratically au·to·crat
1. A ruler having unlimited power; a despot.
2. A person with unlimited power or authority: a corporate autocrat. .
A change in responsibilities
Survey respondents were asked to indicate whether each of nine specific responsibilities was included in their job functions - liaison Liaison may refer to:
Independent government commission charged by the legislature with setting and enforcing standards for specific industries in the private sector. The concept was invented by the U.S. . Physician managers were also asked to specify the percentage of their time spent in each area, its perceived per·ceive
tr.v. per·ceived, per·ceiv·ing, per·ceives
1. To become aware of directly through any of the senses, especially sight or hearing.
2. To achieve understanding of; apprehend. value to the organization, and which was the most rewarding.
Unexpectedly, quality management duties and strategic planning responsibilities were ranked equally as the prime responsibilities for physician executives in all organizations. Clearly, quality management continues to be a key duty of these managers; however, this responsibility is giving way to an equal involvement in strategic planning issues, including budgeting and program development. Physicians are transitioning from technicians to managers, from the doctor managers to the executives who have medicine as a specialty area, not unlike other managers. such as finance and engineering directors.
The percentage of respondents with selected duties is indicated in Figure 1. including the percent of time spent in each noted category (indicated) in parentheses See parenthesis.
parentheses - See left parenthesis, right parenthesis. . While the majority of time is spent in liaison between administration and medical staff for hospital and group managers, managed care physician managers spend most of their time in quality management activities.
Liaison between medical staff and administration and quality-management were perceived by these physician executives as their most important and valued contributions to their organizations. Similarly, duties in education and as a liaison between medical staff and administration were cited as the responsibilities enjoyed the most.
In contrast, hospital physician managers in the 1990 survey indicated that their greatest value to the organization was in strategic planning and indicated that those activities were also enjoyed the most. Group practice physician managers indicated that supervising physicians supervising physician Medical practice A licensed physician in good standing who, pursuant to state regulations, engages in direct supervision of physician assistants whose duties are encompassed by the supervising physician's scope of practice was their greatest value to their organizations, but strategic planning was what they favored most. Managed care physician managers cited quality assurance activities as having the greatest value and also the responsibilities they enjoyed the most.
Ten year findings - hospitals
Fifty-one Adj. 1. fifty-one - being one more than fifty
cardinal - being or denoting a numerical quantity but not order; "cardinal numbers" percent of respondents were full-time full-time
Employed for or involving a standard number of hours of working time: a full-time administrative assistant.
full Senior Medical Managers in hospitals. Average total compensation levels continue to rise well above the rates of inflationary in·fla·tion·ar·y
Of, associated with, or tending to cause inflation: inflationary prices; inflationary policies.
Adj. 1. change in all organizational types. of the three categories, hospital physician executives reported the highest percent increase in total compensation in 10 years, but continue to be paid less in total compensation than those in group practice and managed care.
* During the past 10 years, the differential
in compensation levels from
younger physicians to
older physicians has
Although 50-59 years
of age continues to
represent peak earning
received more competitive
packages in recent
* Hospital senior physician executives
continue to be mostly men. While
our search activity suggests an
increase in acceptance of women in
senior positions, the data do not
reflect this change.
* The percentage of physicians who
continue to have clinical practice
responsibilities has decreased.
Clinical practice at this level is no
longer critical for success, given the
limited amount of time available for
* The percentage of physician executives
who receive a
bonus or incentive
in addition to base
salary and benefits,
has increase 25
percent in 10 years. * Primary care specialty
pediatrics pediatrics (pēdēă`trĭks), branch of medicine dedicated to the attainment of the best physical, emotional, and social health for infants, children, and young people generally. , and
in these roles have
increased to 62
percent from 40
percent in the mid
* Twenty-one twenty-one: see blackjack. percent
of these physicians
expect to be
in a new management position in a
new organization within the next five
Ten year findings - groups
Full-time Senior Medical Managers in groups continue to be paid more total compensation than their counterparts in hospitals and managed care. Average total compensation levels continue to rise, but at a level only slightly above the inflation rate.
* The percentage of medical directors,
who are specialists in family practice
or internal medicine, increased twofold
in 10 years.
* The percentage of group medical
directors with written employment
contracts has increased significantly,
higher than those in either hospitals
or managed care.
* Female medical directors in groups
seem to be making some inroads inroads
make inroads into to start affecting or reducing: my gambling has made great inroads into my savings
inroads npl to make inroads into [+
into part-time part-time
For or during less than the customary or standard time: a part-time job.
part positions@ otherwise,
management positions in group practice
continue to be male-dominated.
* Physician executives in senior manager
positions who maintain a clinical
practice have decreased by more
* Physicians in these positions as their
first management position has
decreased dramatically, suggesting
the importance of prior management
experience for the successful
* Over the next five years, 51 percent
of these physicians expect to remain
in their current organization but have
new or different duties.
Ten year findings - managed care
Total compensation for Senior Medical Managers in managed care continues to be on the rise, at a level double the inflationary rate.
* Managed care continues to be the
place where, on the average, we
found the youngest physician executives,
although ages are similar to
those in group practice.
* The percentage of managers having
clinical duties has dropped significantly
and clinical practice is only a
small part of their daily duties.
* The percentage of organizations that
provided bonuses or incentives to
increased to 76.2
the necessity of
these payments for
of these executives.
* Within five years,
30 percent of these
expect to be in new
in new organizations.
Average total compensation, which includes cash compensation of salary and bonuses or incentives in each health care organization type, is illustrated in Figure 2.
Physician managers in groups reported the lowest compensation levels in 1986 but the highest level in 1995, which could account for the portion of physician managers who continue to have clinical duties. Hospitals and managed care physician managers, total compensation have been competitive throughout the 10-year span, with each category reporting total compensation well above the aggregate for each year.
It is not so surprising that change continues to be the future for physician executives. While trends over the 10 year period are moving in a positive direction for physician executives in compensation, benefits, and attitudes, we expect even with the many changes the health care field is experiencing that it will continue. As the industry continues to evolve Evolve may refer to several terms:
Organizations are realizing the value of a physician leader and physician input on clinical and management issues. In addition, we expect the physician executive role in practice management and managed care to increase significantly as proven by our increase in search activity in these areas. Patience, teamwork, and listening skills will help physician managers find their success along the way.