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Clinical experience and business acumen are important factors in a successful healthcare leader, but the ability to accept change and help an organization adapt are perhaps the most critical.
The one constant in healthcare is that industry leaders must enter their roles with the understanding that little in the field ever remains the same. “We are an inherently complex industry and we shall always be complex, that’s just who we are. Any leaders need to accept this degree of complexity and the ambiguity that goes with it,” says Peter B. Angood, MD, FRCS(C), FACS, MCCM, chief executive officer and president of the American Association for Physician Leadership. “It’s an ever-changing environment, so just being able to know and expect that is important.”
It’s one thing to say that this volatile time in healthcare presents special challenges, but Angood says that’s just the name of the game. “We tend to say this is a very complex time in healthcare and there is dynamic change, but the inference on those types of comments is that there’s some kind of outcome at the end of this,” he says. “There’s no new plateau, it’s who we are as an industry so let’s just get comfortable with it.”
Healthcare leaders must be able to provide a strategic vision and interpret which new trends in this changing environment are a good fit for their organization, says Angood. “It creates kind of an innovative and entrepreneurial approach to things, to not react to everything that comes by. Not everything needs to be followed, but important trends need to be picked up on,” he says.
Here’s more on the crucial skills that leaders must develop to thrive in this dynamic marketplace.
“The increasing focus on patient experience and shared decision making is an important trend that many say is long overdue, but it also requires a significant amount of change,” says Angood.
The challenge of improving patient experience from a leadership perspective is to better manage patient-centered care and shared decision making while also helping patients understand the complexity of healthcare, he says. Leaders need to create an environment that allows patients to have an active role in their healthcare and have a good experience while also making them realize that what is good for them may not always be what they want.
How to accomplish this? An improved patient experience starts at the frontline, says Paul DeChant, MD, MBA, a senior advisor with Simpler Healthcare, a management consulting firm with a focus on Lean transformations. The CEO’s role is not to offer a better patient experience, he says, but to support those that can. “All those frontline folks report to a supervisor who reports to a manager who reports to a director,” he says. “All that focus is on healing, and that’s the responsibility of the people on the frontlines who need the support of the chain of command.”
One way those at the helm can support the frontline is to focus on their well-being, particularly the clinician providers. Healthcare leaders need to address caregiver burnout and attempt to resolve their frustrations within the system. “How do you manage the paradox of improving systems that are slow and gradual while also improving the work environment of providers?” says Angood. “You have to be collaborative and listen a lot. More and more what I’m appreciating is there’s a sense of humility leadership provides that, by being humble, promotes a sense of trust and accountability.”
DeChant believes that crucial healthcare leadership skills aren’t completely centered in professional background, but also in mindset. “Right now, things are so uncertain that leaders need to develop organizations that can have the ability and agility to rapidly respond to changing external conditions and have the courage to take actions as they are indicated,” he says. “Those are key business skills anyone in [a healthcare leadership position] needs to have.”
One example of the importance of organizational awareness is appropriately navigating the growing trend of mergers and acquisitions. Managed care leaders must be well-versed in negotiating, and possibly creating larger market shares. DeChant warns that expansion must be carried out in an exacted and careful manner. “If you have an operation that is managed in a mediocre manner to start with and you acquire another operation, now you have two mediocre managed operations, so you don’t give society a benefit. It’s really important as organizations combine that they focus on ensuring they have the best possible management system across the entire enterprise.”
Another example of the importance of organizational awareness relates to understanding how healthcare reform (and how a potential ACA repeal) could affect the organization.
Angood points out that many large purchasers of health insurance are withdrawing from offering strong benefits for their workforce, which could result-alongside changes to government benefit programs-in a higher percentage of individuals without insurance coverage. He notes this could be a challenge for provider organizations. “It’s uncertain where the financial models are going to come into place and the compensation strategies for both institutions and individuals,” he says. “That’s going to create a large challenge for leadership and management, and how to stay healthy during that downturn in compensation.” Leaders at provider organizations must prepare for these challenges by sharpening their skills for negotiating reasonable contracts with payers and by making sure they have a strong financial team in place with a nimble chief financial officer, he says.
Collaboration is an important component of good management and leadership, and Deborah Torain, senior account manager at the Center for Creative Leadership (CCL), says it’s a critical aspect of helping an organization adapt to an evolving environment. In fact, a 2016 white paper Torain co-authored for CCL specifically points to collaborative patient-care teams as the first essential component of a six-step model to help healthcare entities thrive. To develop collaborative teams, leaders must increase engagement and foster an atmosphere that allows for agility and adaptability.
Additional steps highlighted in the CCL white paper include transforming talent and expanding boundaries. Healthcare leaders must find new ways to bring individuals into roles that can effect positive change and innovation. This may mean bringing in individuals from outside healthcare, or helping those working in the industry expand their talents and skills.
In terms of background, physician leadership is still seen as the gold standard, but leaders with a nonmedical background offer certain advantages, such as an individual with a technology background, says DeChant. “… As the world is changing and so many more interactions are happening online or other virtual ways, we need someone with an understanding of what those are and what the opportunities are,” he says.
He adds that individuals familiar with Lean Six Sigma methodology, which is particularly valuable in identifying efficiency improvements, are also an asset. In general, individuals from outside healthcare might bring additional insight when it comes to efficiency improvements, offering a sense of business discipline that DeChant says that, up until several years ago, the healthcare industry had the luxury to ignore. Costs must be reduced, he says, adding that the national cost of healthcare-at 20% of the gross domestic product-is making U.S. healthcare noncompetitive on the global scale.
Still, leaders with medical backgrounds also bring important assets to organizations. “For the most part, you’re a much better leader if you understand the operations,” he says. “We need fresh ideas, but we can’t lose our core.”
Torain agrees there are benefits to having leaders with clinical training. Healthcare leadership isn’t a huge leap from a physician’s clinical role, but rather broadens the scope of the role they can play, she says. “Being able to bring in areas of expertise is truly critical, but to not miss any voices is an important piece,” she says. “Expertise can be enhanced. When we go so far off the mark without that direct experience, training, and the clinical aspects of patient care, key elements can be missed.”
Rachael Zimlich is a writer in Columbia Station, Ohio.