By Mary K. Totten and James E. Orlikoff

Hospital leaders around the country are experiencing growing pressures, challenges and changes in their relationship with “their” physicians. Physicians also play a variety of changing and often conflicting roles with the hospital—partner, competitor, employee or independent contractor.

On one end of the spectrum are disinterested and uninvolved office-based physicians. On the other end are hospital-based physicians whose finances and futures are inextricably intertwined with those of the hospital. As these critical relationships evolve, several new realities are emerging. The first is the disquieting truth that hospitals need physicians more than most physicians need hospitals. The second is that each physician is unique, with different expectations and attitudes based on variables, that include, but are not limited to, his or her age, gender, specialty, income requirements, family situation and personal history. The third— and for hospital leaders perhaps the most challenging truth—is that the traditional vehicle for housing, organizing and facilitating the practice of physicians within the hospital, i.e., the hospital medical staff, is rapidly losing currency and may soon be an organizational dinosaur.

The Demise of the Traditional Medical Staff
The traditional medical staff model was originally designed during a period of financial robustness, when both hospitals and physicians could be independent, yet codependent. They were both relatively unaccountable to each other and rewarded by a payment system that reimbursed hospitals for their costs, or beyond them in some cases. Today, this model is showing its age and inappropriateness as the health care market squeezes out inefficiencies at every turn, demands quality and transparency that can best be achieved through real teamwork, and does not tolerate variations in cost and quality.

Symptoms of the declining utility of the traditional medical staff include physicians who: refuse to take emergency department (ED) call without compensation; open ambulatory care facilities that compete with hospitals for profitable patients; don’t attend medical staff meetings; are reluctant
to serve as medical staff leaders; and have an adversarial relationship with administration over resource allocation, capital acquisition, strategic planning, quality improvement and patient safety efforts. Most hospitals and medical staff leaders are responding to these issues as they emerge, addressing the symptoms of the problem instead of the core challenge.

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More Information

Join your colleagues April 6-9 in Washington, D.C., at the 2008 AHA Annual Membership Meeting. This year's agenda includes several sessions designed specifically for hospital trustees. Tickets for each event are $35 per person, with the package of three sessions plus the trustee breakfast available for $125.

Session Topics

• Success in Succession Management: Preparing the Next Generation of Leaders
  V. James Fiorenzo, RPh, MBA, Executive Vice President, Chief Operating Officer, Hamot Medical Center, Erie, PA and Eric Hanson, Executive Consultant, Development Dimensions International, Pittsburgh, PA
  
  
• The Board's Role in Quality and Patient Safety: Practical Tools , Tactics, and Techniques The Role of the Health Care Trustee
  James E. Orlikoff, President, Orlikoff & Associates, Inc., and Senior Consultant, Center for Healthcare Governance, Chicago, IL
  
  
• Trustee Leadership Breakfast National Political Update
  Amy Walter, Editor in Chief, The Hotline, Washington, DC
  
  
• The Gremlins of Governance: What Keeps Me Awake at Night?
  Richard Chait, Research Professor, Harvard Graduate School of Education, Cambridge, MA

More Information and Session Descriptions

The Center for Healthcare Governance wants members to be as connected as possible to our governance consultants. Being able to ask questions online and receive responses back quickly will ensure you'll find the answers and resources to help you achieve excellence in health care governance.

Please fill out the Center's Ask the Governance Expert online form with your specific question or request, and you will be contacted within 24 hours with a reply. In addition, please feel free to use this form to submit feedback about the Center's services so that we can better serve you.

Please note that this is a member-only resource. Only submissions by Center members will be answered.

The Center for Healthcare Governance developed Speakers Express to help make the high-caliber speakers and presenters found at its national symposia and regional workshops available to organizations throughout the country. Our speakers are proven professionals who are viewed as the "go-to" leaders in their respective fields of expertise, customizing their presentations to fit the unique needs of each organization.

The Center for Healthcare Governance introduces Connie Curran, RN, Ed,D, FAAN, a faculty member of the American College of Healthcare Executives and one of the most prolific scholars in the field, with more than 200 publications and several research programs to her credit. Learn more about Connie Curran below:

Connie Curran, RN, Ed.D, FAAN Speaker Bio Presentation Topics

More Information on the Center's Speakers Express

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