Article

Steward Medical Group COO Mark Scheyer shares 7 insights for surviving and thriving in change

By Carley Thornell | October 13, 2020

""

Steward Medical Group COO Mark Scheyer says by having smaller practices in several locations, his organization is able to make care more accessible.

Steward Health Care recently became the largest physician-owned and operated health system in the United States. Steward Medical Group’s Chief Operating Officer Mark Scheyer has seen the group’s number of practices and providers triple in his six-year tenure, which he credits to an organizational structure that prioritizes the input of doctors, along with the right technology to support care coordination and growth. As the 36-hospital organization faces one of the most challenging times in modern medicine, Scheyer shared his perspectives on communication, leadership — including serving in many roles across the medical community — healthcare disparities, and more.

You’re in a pivotal time of unprecedented change, between a structural transition and a pandemic. What takeaways can you share from an operations and leadership perspective?

If COVID happened a year ago, Steward Medical Group would have had  a more difficult time quickly navigating the ever-changing landscape associated with managing through the pandemic. We didn’t have the same technology available to us that we have today and we could not have made decisions nearly as fast.

And it may be very cliché to say, but your team is one of your most valuable assets. Getting the right people in the right places in the time that we did, having some consistency of how we leverage technology across the continuum is important. We've done a really good job for the most part in communicating [with employees]. You can get caught up in the day-to-day stuff and it's hard to take a step back. You need to keep a short- and long-term perspective, communicating and getting feedback so that you can manage through these really challenging times.

When Steward President Michael Callum, M.D. shared his 2020 predictions with us, the increase in telehealth services has proved remarkably salient. What are some internal strategies in regard to leading online?

I'm definitely not traveling nearly as much as I was in 2019. But it's interesting because you can reach just as many people, if not more [virtually]. So, I held my first National Operations meeting virtually in July. I usually hold a monthly director meeting and we have usually 50 people. However, in this National Meeting we had over 200 people from across the country live on our video call. But without getting on an airplane, I can talk to as many people as I want to.

Can you share how Steward’s structure assisted during the pandemic?

A lot of larger healthcare organizations are so complex, and very matrixed. If there was a company that was probably best positioned to manage through COVID, Steward's probably one of the top ones because we go through an annual budgeting process that really vets every dollar spent throughout the healthcare system, so that we kind of flush out any of the additional layers that don't add value to care for our patients. Steward maintains a very lean organization and there are not too not many layers [of management] so we can remain as efficient and responsive as possible.

How do you streamline and maintain focus across such a large organization?

A big part of our strategy over the past year has been to get everyone on the same [ambulatory] EHR. The system has really come together over the past couple years. It was really hard to maximize and optimize our practices when we had three, four other EHR systems that we were using across the medical group. Obviously, that impacts how we work. So our attention was constantly bouncing back and forth across different regions and different EMRs which was a disservice to our practices.

What’s your take on balancing organizational growth and patient care?

For us, it's really about access – how do we get patients into our practices from both the medical group and  from outside institutions and entities? From a care-coordination perspective – we want to know where all of our referrals are going for high-tech imaging, and for specialist visits. We’re now able to track referral patterns in real time much better now than we could six months ago. If we can improve care coordination as a system, we will be able to care for our patients at a lower cost and eliminate the need for redundant tests, studies, and be an attractive partner for our payors. Part of our care coordination strategy is also calculating the right complement of employed providers and network providers.

In terms of hiring new employees, you’ve worked as a practice manager and as a physical therapist. How does being in the field, in addition to having a management degree, inform your hiring philosophy?

I first started out treating patients as a physical therapist and became interested in healthcare administration/management after my first facility manager role. Following graduate school, I worked as a practice manager for a three-provider dermatology practice. While rebuilding the dermatology practice, I sat at the front desk. I scheduled and registered, I managed the EHR,  and I was responsible for the practice financials. People respect that I have a clinical background because I can say, ‘Hey, you know what? I remember taking care of patients.’ In addition, I've basically done all of the jobs that everyone is expected to do under me within our practices. It’s really important that you hire people who have specific practice management experience because the providers and staff will respect you more. That’s why I find recruiting and hiring senior practice management executive so hard — because we’re so large, there aren’t too many medical groups our size, and there aren’t enough people who can do this at a high level. Therefore, I do my best to promote our administrators from within Steward as we continue to grow.

Steward leadership has spoken out about racial disparities recently. Your CEO Ralph de la Torre says the pandemic “has exposed serious deficiencies in the world's healthcare systems with a disproportionate impact on underserved communities and populations.” How are you addressing this?

There's a ton of money in healthcare that goes towards procedures and surgeries, and less so into the population health world. What Steward originally set out to do was to participate in ACOs, taking on risk so that we can take care of patients and better serve them at a lower cost within the communities that we serve. Steward Medical Group takes care of our patients by strategically placing practices throughout communities that need our services and we typically average three to four providers per location. Our goal is to provide better access to care, which contributes toward the mission and vision of providing high-quality care in the communities that we serve.