Medical practices that once focused almost solely on the quality of care are increasingly including profitability and long-term viability in their strategic plans. The cultural changes that necessarily must accompany these conversations can be unsettling, at best, and devastating, at worst—unless steps are taken to make the cultural-transformation process as seamless as possible.
Key to smooth cultural change is effective, meaningful communication throughout the organization, according to Doug Smith, managing partner of strategic positioning and consulting solutions for Integrated Medical Partners (IMP). Partners, physician associates, nurse practitioners, medical assistants, physician assistants, practice managers/executives, staff, and even patients must understand the practice’s mission and core strategic imperatives. Physicians and staff alike must live those, every day, with their customers (hospital leaders, referring physicians, third-party payors, and patients).
This communication can and should be supported through the sharing of meaningful and differentiating information derived from sophisticated business intelligence, analytics, and informatics tools, Smith says. Business intelligence works to drive and reinforce cultural change because of its pure objectivity: The information is not polluted by considerations such as personal agendas, factional conflicts, or misinterpretation of raw data.
Evolution of Medical Groups
Smith’s consulting experience has exposed him to many practice environments in which cultural change could have been facilitated by the use of well considered and supportable business-intelligence tools. “The pressures in patient care have increased dramatically over the past decade, and more senior physicians are quitting due to the increasingly complex business demands on the practice of medicine, increasing regulatory changes, or proliferation of defensive medicine,” he notes.
“When we speak about adaptive practice cultures that have evolved, though, we must also take into consideration the effects of consolidation and integration, including a continuous trend of physician-practice mergers and other affiliation constructs,” he explains. “As a result, more complex organizations are evolving to meet the demands of modern practice, and such organizations require a leadership culture that includes the infrastructure demands of governance and management, on top of their serious clinical responsibilities. Physician leaders need to get their arms around understanding the differences and demands of these more diverse and complex organizations operating in a more complex and fast-paced environment as quickly as possible.”
Smith observes that in today’s complex health-care environment, holding on too closely to past patterns of decision making and leadership can be extremely detrimental to the health of a practice. “Today, the speed with which decisions are made is crucial,” he says. “Practices can no longer afford to have 20 or 30 people sitting around a table, making decisions as a group. They need to make crisp, well-informed decisions. Delegation of authority, for certain decisions, by the partner group to a more streamlined body is essential in today’s universe.”
In the practices with which he works, Smith has seen indications that medical groups are evolving in this direction. “What we are seeing is a progression where groups will eventually be in a position to make decisions swiftly and confidently,” he says. “More and more, they will be constructing an executive committee and other management teams and delegating certain authority and accountability to them.”
Role of Business Intelligence
Today’s medical practices are increasingly reliant on the use of business intelligence to support both short- and long-term decision making. Smith notes that incorporating measurement into decision making represents a cultural change for many physicians and practice managers, who might previously have been more focused on the clinical side of the business.
“Metrics are a decision-support tool for business, and they are required to help make crisp decisions in this fast-moving environment,” Smith says. “The new culture for medical groups should be one that emphasizes the importance of good patient care, but equally recognizes the need for people who understand the financial health of the practice and understand what it is going to take to adopt new strategies to survive and thrive.”
Developing these measures