Employed physician networks have become an integral part of the overall strategy for hospitals and health systems. Whether your network consists of 40 or 240 providers, having the right executive leadership at the helm is critical. And the operational and financial expertise required to effectively manage these multimillion dollar entities has grown with the network’s size and complexity.

HSG has placed interim executives and performed executive searches for clients around the country. Financial losses aside, we have found consistent themes in the challenges and frustrations expressed by clients requesting that type of assistance. If any of the situations below ring familiar, it may be time to make a change to, or upgrade of, your employed physician network management team.

Driving without a dashboard. Routine monitoring and reporting of key performance measures is not occurring. Leadership is unable to stay apprised of performance areas needing improvement and, therefore, unable to define actions to effectively address operational issues, stem losses, and keep localized problems from becoming systemic problems.  At a minimum, network management should provide senior leadership with a weekly dashboard summarizing operational and financial indicators and metrics.

Tired of asking for information. If you are constantly having to ask for management and performance information, you’ve got a problem. Effective network leadership should be proactively meeting with you to review operational performance metrics and the status of projects, plus working with you to help plan for what lies ahead.

Who’s the boss? I had a client recently tell me that, during an interview process, the management candidate stated that he was “great at working for docs”. While appropriate for independent practices, that mindset misses the mark for employed groups. Network leadership must to be able to work well with physicians to achieve objectives, but there should be no confusion about who’s the boss or the need to focus on the best interest of the health system when setting strategy and making financial decisions.

This is also applicable to network physicians, many of whom came out of independent practice and sometimes have difficulty acclimating to changes in their role. Network leadership that sees its role as “working for docs” will not be successful in smoothing needed transitions.

Lack of physician engagement. As healthcare shifts toward value-based care, it becomes increasingly important to develop physician leadership and governance in the network to evolve the network capabilities in support of system goals. It’s a red flag if network leadership is either unable or unwilling to develop opportunities for physician input and engagement through initiatives such as a Physician Advisory Council, service area leadership, participation in development of the group’s strategic priorities, etc. And, not only should physicians be involved in defining goals and action steps, they should have specific roles in implementation.

The Ivory Tower executive. Isolated leaders are seldom effective leaders, and this is particularly so for employed networks comprised of multiple, previously independent practices. An effective network leader will have the foresight to put together a team of directors/managers to help him or her manage the day-to-day operational and financial items, freeing up time to do some “management by walking around”. Visiting the practice offices, and being visible and accessible is invaluable to understanding and addressing challenges. If your visits to network offices find physicians and staff haven’t seen the network executive, that’s concerning.

Knock, Knock. One of the most telling signs that you may need to consider a leadership change is network physicians increasingly coming to YOU or other C-Suite executives with items/issues about the network. Providers should feel comfortable discussing concerns with you. However, if you are becoming bogged down with operational and financial discussion with providers, you’ve got a problem.

The growing complexities of employed physician networks require increasing resources and expertise to manage, and it’s important to have the right leadership in place. If any of the above sound a bit too familiar, it may be time to consider an upgrade of your executive management team.

Travis Ansel

Chief Executive Officer and Managing Director, Strategy