Over the last several years, physician employment has been a strategic focus for hospitals. The reality is that many physicians are unable to maintain a private practice due to declining reimbursement rates and continually increasing expenses. Healthcare reform has forced many to rethink their overall alignment strategy. As a result, hospitals have made significant investments to grow their employed physician networks with an emphasis on core services and primary care specialties. However, as employed physician networks have grown, many hospitals find themselves unable to successfully manage these networks. As a result, former executives, administrators and practice managers are being recruited to provide leadership on an interim basis. The most common reasons for interim management are:
- Issues and challenges of the organization have outgrown current management and leadership.
- Mounting losses within the hospital and/or employed physician network.
- Turnover of management and leadership.
- Growth in the employed physician network demands leadership with an enhanced skill level.
Interim management can be a very effective strategy. A successful interim engagement requires the right leader with the right skill set that can effectively engage senior management and key physicians in designing and implementing change. Interim managers can help transition an organization through its challenges and serve as a change agent that has authority to impact decision making. Below is a five-step plan for a successful interim engagement.
- Identify and Create Awareness of the Issues: In order to address problems, first identify the issues. Effective interim managers will not only engage hospital management, but also key physician stakeholders. Often times, hospital management and physicians have different perspectives. Asking the right questions will create awareness of the issues and generate constructive dialogue.
- Prioritize the Issues: Prioritizing the issues is one of the most important aspects of an interim engagement. The job of the interim manager is to work closely with management to determine which items must be addressed first. For hospital management, reducing practice losses or fixing inefficiencies in the physician practices may be the top priorities. For physicians, the top priorities might relate to having more autonomy and better practice support.
- Assess the Issues to Determine the Root Cause: How did we get here? Before an action plan can be put in place, interim managers must spend sufficient time assessing each issue. Are the problems due to a poor infrastructure, lack of demand, cultural differences, ineffective management, poorly structured compensation plans or operational inefficiencies? Effective interim managers will objectively work through these details and recommend a course of action based on their past experiences and knowledge of managing practices.
- Create Action Plans to Address Issues: Once the issues have been identified, the interim manager must create action plans to address each issue. Action plans must be clear and concise, with measurable goals and objectives. Each plan must identify the resources needed, both internal and external, as well as the amount of time required. Action plans will serve as a roadmap to a stronger and more effective physician network.
- Monitor the Results: The interim manager should monitor the results of each action plan. Monitoring the results will create accountability and ensure that goals and objectives are met. Once immediate items are addressed, the process can be repeated to address long-term issues.
This is a powerful strategy if utilized correctly. Without adding to an organization’s FTEs, it allows for outside resources to objectively influence decision making and enact change when change is not welcome. In other words, an interim manager can be the bad guy and act as a buffer to management. Consider the impact interim management will have on your organization and decide if the time is right to implement this strategy.