By JULIE MINDA
Like most health care organizations, Cincinnati-based Mercy Health has been restructuring its operations over the past several years to yield better performance under health care reform. It's moved from a decentralized, regionally focused structure to an integrated, centralized organization. It is using population health management approaches as it has assumed more monetary risk for patient outcomes.
It's called on physicians to function as team leaders, collaborators and, in some cases, management experts. To equip its physicians for such roles, in 2015 Mercy Health began offering a yearlong leadership and formation course called Leadership in Medicine. The program builds management, communication and collaboration skills; and teaches physicians to apply what they've learned to their work at Mercy Health facilities.
"We realized we needed to be physician-led, and as we were looking at how to develop integrated networks, we knew we needed to be closely aligned with physicians and to have a pool of physicians" available to assume leadership in the restructured organization, said Dr. Herbert Schumm. He heads Leadership in Medicine and is Mercy Health's medical director for provider and professional development.
Dr. Cari Ogg took the course last year as she transitioned from being a general surgeon with Mercy Health Physicians — Cincinnati, to becoming that physician group's chief medical officer. She said, "It's a different process when you have a patient in front of you and you're determining what to do than when you face decisions as an administrator. We're not, as doctors in clinical roles, given the tools we need to be good administrators. This course is great to start building that toolbox with what you need to be effective."
Two heads better than one
Dr. Paul Buchanan, chief medical officer of the Mercy Health Partners physician group in Springfield, Ohio, was in Ogg's 2016 Leadership in Medicine cohort. He said when the Affordable Care Act was signed into law in 2010, Mercy Health began to adjust to the new climate by trying to eliminate the "silos" in the organization. The changes were intended to help clinicians share best practices, more effectively implement care standards and adopt population health management approaches.
In the last several years, Mercy Health has been shifting to a dyad management model, in which a clinical leader is paired with an administrative leader to manage a facility or division. Dr. James Kravec, executive vice president and chief clinical officer of Mercy Health's Youngstown, Ohio, facilities, said physicians with leadership and administrative experience perform well under this model, and so it will benefit Mercy Health to have an ever-growing corps of physicians prepared to take on roles in the dyads.
Hard and soft skills
Mercy Health regions nominate physicians with high potential for leadership to take part in the course. About 40 physicians can participate each year. Mercy operates 23 hospitals and a network of outpatient sites in Ohio and Kentucky.
The course includes two in-person gatherings that span three days each. Before those meetings, participants complete assigned reading and self-awareness evaluations. Colleagues who they work with directly also complete evaluations of them to provide feedback on job-related skills and performance. In between the in-person conferences, each region holds several small group workshops.
Leadership in Medicine covers differing leadership styles, skills and attitudes; time management; networking; resiliency; holistic health; physician wellness; conflict management; and Mercy's faith-based mission, among other topics.
Participants can initiate projects at their place of work and hone them with input from fellow leadership academy students as well as from other Mercy leaders. Projects might include bringing a new service line into an integrated network. The projects must be in line with Mercy's strategic goals.
There is one cohort per calendar year; and by the end of this year, about 120 Mercy physicians will have completed the course. According to information from Mercy, about three-quarters of physicians who participate in Leadership in Medicine go on to work in new — or in some cases expanded — leadership roles at Mercy.
Schumm said course graduates have an informal alumni network and turn to one another to provide and receive advice on challenges they face as newly minted managers. When system executives are forming committees or seeking to fill physician leadership positions, they can draw candidates from the roster of leadership academy graduates, said Schumm.
Mercy also is putting in place a physician mentoring program, and physician graduates of Leadership in Medicine likely will be invited to be mentors.
Ogg said the pre-course self-assessment and the assessments completed by her work colleagues helped her better understand herself and how others perceive her.
The 2016 cohort of Leadership in Medicine participants gather during an April 2016 session at the Kalahari Resort and Convention Center in Sandusky, Ohio.
The course trained her to be a better listener in a team environment and to seek out ideas from people with different perspectives. She is now keenly attuned to the leadership styles of others.
She said the training also helped her learn some life lessons. She said she got a better understanding that "you learn from your failures as well as from your wins. Learning to accept that and know that you're not going to win everything you put forward helps you to develop the emotional intelligence you need to survive in a leadership role."
The course also helped her to realize, she said, that "change can be good, and I now think about how I can be creative in driving change."
Buchanan said a favorite aspect of the course, for him, was the interaction with physician leaders from across the system. "In groups, we discussed the difficulties we have and tried to come up with new approaches. We lifted up everyone's game."
Buchanan has kept in touch with some of the physicians he met during the course and plans to continue to tap into the alumni network.
He said the course content on physician wellness, preventing burnout and carrying on the mission of Mercy Health was inspiring to him and others. "Mercy has a great gift for touching people spiritually.
"We got a deeper understanding of the mission of Mercy, and it instilled a lot of pride in the mission, and now we're trying to take that back to our units and pass it on," he said.
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