Providing quality healthcare is a mission that starts at the top. Clear and inspiring leadership guides strategic decisions, motivates employees, and sends a message that culture is a critical asset. Our research has identified five attributes of effective leadership that are common among high performers.
To thrive in today's turbulent, rapidly changing healthcare market, organizations must have a clear and compelling value proposition for patients and providers, supported by an inspiring purpose. There are many different kinds of successful visions. What matters is that the vision infuses everything the organization does, influencing all major decisions and defining the culture. Privia Medical Group defines itself as a “population health technology company that partners with top doctors to keep people healthy." This vision guides hiring decisions (“top doctors"), determines incentive structure (“population health" goals), and explains the ambitions that motivate the entire organization. Effectively communicating vision, day in and day out, is at the core of a leader's job.
Physician voice in leadership
Top performers include physicians in leadership and rely on their input for strategic decisions. While this is easier in physician-owned and -led organizations, others can achieve the same effect by embedding physician leaders below the executive suite. The most effective physician leaders remain clinically active and are widely distributed throughout the organization. Other physicians trust that these practicing clinicians understand their concerns, dramatically easing the implementation of new initiatives or protocols. Some large medical groups use a dyad model of physician leadership – pairing each regional clinic leader with an experienced administrator. This approach ensures that physicians have a voice in strategic decisions and ensures that operational and clinical goals are aligned across the organization.
Principled growth orientation
Conventional wisdom suggests that growth offers healthcare networks beneficial economies of scale, but our research suggests that the opposite is often the case. Operational diseconomies of scale and cultural mismatch can counterbalance the economic gains of consolidation and growth. Not surprisingly, the key is to pick the right targets and grow with specific and strategic intent. Summit Medical Group, comprised of more than 550 physicians, has been growing by around 75 physicians a year. But the organization does stringent due diligence before bringing on new practices, and is committed to walking away from any practice that does not fit the overall culture, no matter how attractive it looks financially. Post-acquisition, Summit has a comprehensive integration process that includes two to three weeks of onsite onboarding activities and six to 12 months of integration support.
Hiring for fit
New providers and staff can either reinforce the group culture or change it in potentially unwanted ways. The best approach to promoting and maintaining the culture of an organization is to hire the right people from the start — even if that means passing up a renowned specialist in favor of someone right out of medical school. At one high performing specialty organization, new hires are expected to meet aggressive productivity and revenue targets, but more importantly, are expected to be self-starters who will fit with the rest of the team. Candidates interview for an entire day, and providers and staff have veto power over even the most financially promising candidates. Only one out of every eight candidates is offered a job.
Defined accountability structures
Among top performers, each important business or clinical goal is assigned to a dedicated senior leader who is ultimately responsible for achieving it. Executive leadership broadly communicates this accountability structure throughout the organization, and empowers individual leaders to promote real improvements. At one large organization, the CMO, along with specialty leadership, determines overall goals in alignment with strategy and payment programs. Every month, clinical leadership conducts a monthly quality review call with each market to review performance against agreed-upon goals, barriers and next steps. While certain processes are standardized, practices in individual markets have leeway in how to achieve their goals.
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