Ten Questions for Building a Physician Strategy

Few relationships are more central to the success of the hospital than the one between the organization and physicians. And, this relationship only grows in importance as physicians increasingly compete with hospitals.

To cement a strong relationship, the organization should address 10 vital questions:

1. Is there trust among the physicians, the CEO, and the board?

There must be mutual respect and a solid commitment by all parties to be straightforward and truthful. If trust does not exist attention must be focused on improving it.

2. Is there a shared focus on quality care?

A shared focus creates a tighter bond, and quality discussions can lead to discussions on everything from staff credentials, updating technology, treatment protocols, and the speed and accuracy of test results, to communication and working relationships among clinicians, pharmacists, technicians, and others.

3. How and why do physicians make referrals, and how is that process changing?

Physicians make referrals based on reputation, patient request, personal relationships, and sometimes simply who is available. For many reasons the trend is away from PCP’s bonding with specialists. Through focused efforts, your hospital and medical staff can capture more business by asking PCP’s and others for their referrals, smoothing the referral process, handling patient interactions efficiently, and ensuring timely feedback to the referring physician.

4. Is the supply of physicians appropriate to the community’s need?

Faced with a physician shortage in many areas of the country, it is important that hospital leadership and medical staff work together to ensure the community’s access to care. This is accomplished through the development of a plan to address deficiencies in supply. Doing so is complicated, as the federal government heavily regulates recruitment to avoid abuse of the Medicare and Medicaid programs. But, whether you use external or internal resources, the plan is critical to the hospital’s ability to meet need and effectively manage resources.

5. Do you have a method for developing medical staff leaders?

These roles have never been more important. Physician leadership in improving clinical quality and managing utilization is crucial as payers demand accountability and are increasingly under pressure to manage costs. Physician leadership must be addressed aggressively, with succession planning for physician leaders approached in the same way that it is done for executives. There are 4 key questions to consider when addressing physician leadership: 1) What advantage does the physician receive in assuming a leadership role? 2) What specific management roles need to be defined? 3) What skills do physician leaders need and how can the hospital help them to acquire those skills? and 4) How should physician leaders be compensated?

6. Should the hospital have economic relationships that drive common goals between it and key physicians?

Driven by the demand for specialists and the hospital’s need to provide profitable services, employment of and joint ventures with physicians are both growing economic models for hospital and physician integration. Whether to employ or joint venture, the organization should define under which circumstances and for which services it would consider such efforts and address the issue as a part of the overall physician strategic planning process.

7. Is there attractive physician office space close to the hospital?

The physician’s primary assets are knowledge and time; convenient access to the hospital is a major consideration for physicians when determining where to establish a practice.

8. Are physicians growing their practices, and how can the hospital help?

Growth in practices loyal to the hospital will translate into growth for the hospital. So, helping physicians grow is a good investment. The hospital can help by recruiting new associates where needed, increasing referrals into the practice through liaison representatives and physician finder services, building awareness through targeted advertising, and other similar measures.

9. Does your information system enhance clinical practice?

Information technology is changing the practice of medicine. From results reporting to remote-site scheduling and electronic medical records, technology is helping physicians in their clinical decision making. To support its medical staff the hospital must stay current with information technology.

10. Do you have resources to help key practices that are in crisis?

It is not unusual for a practice to struggle with billing and collections, governance, staffing, financial reporting, compensation, and productivity. When such problems afflict a practice critical to the hospital’s long-term success, the hospital is at risk. An effective approach to helping physician practices thrive is to have available core management resources, such as expertise in billing and collections, strategic planning, and compensation systems. A downside to this assistance can be the perception of favoritism, as some practices are helped and others are not, so the process must be well managed with sensitivity to the political climate.