A Seat at the Power Table: The Physician’s Role on the Hospital Board

About the Authors:
Jayne Oliva is principal with the Croes Oliva Group, a team of medical group management diagnosticians which works with health care organizations and their affiliated physicians, as well as private practices, to improve front-line operations and boost performance in profitability, productivity, patient access, and patient care coordination. She also coaches and mentors physicians for optimum leadership performance. Jayne holds an MBA from the Kellogg Graduate School of Management at Northwestern University. She teaches graduate level courses in outpatient care delivery and physician practice management, speaks nationally and appears frequently in regional and national publications.

Mary Totten, Director of Content, is a speaker and consultant to hospitals and health systems, and other health-related organizations on quality of care and medical staff credentialing, strategic planning and mission development, governing board orientation and board self-evaluation and governance restructuring. She conducts board retreats and education programs and writes and publishes books, articles, and newsletters for health care leaders, including the American Hospital Association’s The Guide to Governance for Hospital and Health System Trustees, first and second editions; The Board’s Role in Quality of Care:A Practical Guide for Hospital Trustees, The Future of Health Care Governance: Redesigning Boards for a New Era and The Trustee Handbook for Health Care Governance, first and second editions. Mary holds a MBA from the Kellogg Graduate School of Management at Northwestern University.

Overview:
Today’s health care organization boards face unprecedented challenges in the areas of quality, care delivery, financing, physician relations, and information technology. More often than not, trustees seek counsel from members who are successful corporate and civic leaders and philanthropists and activists who draw on their personal and professional achievements to help guide and define health care services in communities across America. Indeed, it is predominantly the board’s business dealers—and not its patient healers—who are reshaping the delivery of health care today.

But as guardians of patient and community health, physicians in board rooms across America maybe in the best position, if not the driver’s seat, to articulate and advance clinical excellence. They bring to the table their unique vantage point, skill set and understanding of process and protocols to help ensure that hospitals embrace and facilitate a mission of health, healing and access for all.

Figure 1: Today’s Challenges for Hospital Boards of Trustees

• Growing consumer demand for information and accountability fueled by the Internet, consumer driven health care and the publication of quality and pricing information by payers
• Growing demands from patients and payers for improved quality and safety
• The effect of the Baby Boomer age wave on health care financing and delivery
• Growth of complementary and alternative medicine
• Technologic innovation in care and delivery, such as telemedicine and robotic surgery
• Treatment advances resulting from genomics and new drug treatment therapies
• Increasing demand for inpatient and out patient services that’s train capacity and resources
• Increasing costs to build needed infrastructure
• Ever declining reimbursement
• A continued nursing shortage and predicted physician shortage
• Shifting relationships with physicians—from one of seeking cordial relations to one of market based collaboration
• Unfunded federal mandates, such as HIPAA compliance
• Cultural competence and sensitivities in delivering care to diverse populations
• Proactively managing patients with chronic medical conditions

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