CONCLUSIONS

1. Physician Leadership Success Model for Large Group Practices The Results of an Interview-Based Job Competency Study Tracy Duberman, Ph.D. & Leonard Fromer, M.D. WJM ASSOCIATES, INC. & GROUP PRACTICE FORUM INTRODUCTION CONCLUSIONS RESULTS RESULTS • We report our results in three main areas, namely leadership competencies, pivotal experiences and derailers that may inhibit success. • LEADERSHIPCOMPETENCIES • A unique competency model has been developed based upon the interview outcomes and psychometric diagnostic. Our research reveals that effective physician leadership requires competence in four main leadership areas: • Leading Self • Self Awareness – Recognizing one’s emotions and their effects; and knowing one’s strengths and limitations. • Self Management – Ability to manage emotions and impulses; and taking responsibility for personal performance. • Self Development– Demonstrating commitment to personal development and a learning agility. • Leading Others • Building Effective Teams – Understanding the individual competencies required for success in the key positions on the care coordination team; recognizing and leveraging team members’ strengths and providing developmental opportunities; and building trust, commitment and alignment with patient and organizational goals, and those of the health system. • Communicating and Inspiring – Creating and communicating a compelling and inspired vision or sense of core purpose; providing logical reasons for choices; and fully articulating ideas with data and logic to reach optimal and sustainable consensus. • Leading Change • Resiliency – Demonstrating personal flexibility; being comfortable handling risk and uncertainty; and able to shift gears in response to emerging priorities. • Courage & Authenticity – Keeping one’s word; fulfilling one’s promise; identifying and acting upon appropriate risks; and saying what needs to be said. • Change Management – Ability to rally teams and entire organizations around a burning platform for change. • Leading for Results • Decisiveness – Making sound and defensible decisions in a timely fashion, especially in times of uncertainty. • Systems Thinking – A mind-set for understanding how things work; a perspective for looking for patterns to seek underlying systemic interrelationships which are responsible for the patterns of behavior or events. • Business Acumen – Bringing a business perspective to the healthcare system, and a passion for the business side of medicine. Given the changes in the healthcare landscape and the challenges that lie ahead, there is a great sense of urgency to identify and develop physician leaders who can effectively position their organizations for success. While a strong clinical background is preferable for physician leadership positions, it is challenging to find physicians with the competencies required to be a strong leader. We recommend early identification of high potential physician leaders who possess integral physician leadership competencies and/or the capacity to develop these leadership competencies. Furthermore, the results of our research indicate that leadership training ought to start early in the educational lifecycle for physicians. We propose instituting a targeted development program based upon our success model early on in a physician’s career, as well as exposure to on-the-job experiences in administration and management. We also recommend instituting feedback mechanisms for physician leaders to allow them to understand how their leadership behaviors are being perceived by others to enable course correction throughout their careers. Long-term solutions such as changes to medical school education are good. However, the need for a new kind of leadership is too urgent to wait for the next generation of leaders. We recommend immediate investment in the development of current physician executives that pull upon three learning methodologies, namely on-the-job experiences, coaching and mentoring to support on-the-job experiences, and formal classroom learning with a focus on systems thinking, process improvement methods, communication and conflict management skills, change management and teamwork. • Our research with a sample of 65 physician executives from the American College of Physician Executives revealed several leadership challenges resulting from the changing US healthcare landscape. The top five cited include new challenges for physician executives: • Identifying and communicating metrics to define physician "value" to patients and health partners • Understanding clinical systems thinking and applying the concepts to new models of care delivery • Communicating effectively to engage physicians and other healthcare providers to work as a high performance team • Implementing patient-centered clinical integration • Leading culture change rooted in trust between physicians and the health systems they support • Given these emerging insights about the needs and challenges of physician executives, WJM Associates, an internationally renowned authority in developing executive leaders, in partnership with the Group Practice Forum of the Kinetix Group, a Medical Advisory Board-led network designed to provide group practices with resources and information to achieve maximum clinical effectiveness, have designed an exploratory study to better understand the specific behavioral competencies of effective physician leaders, experiences that raise the level of success, and common derailing behaviors that often impinge on success. This was accomplished by interviewing and examining the competencies of successful leaders of several thriving large group practices. • PIVOTALEXPERIENCES • Early managerial/administrative experiences, such as election to state specialty chapter, serving as medical director and/or residency program director. • Formal Leadership training boot camp & fellowship programs, in such areas as finance, public health, legal, human resources, quality, leadership, communication, change management, and team development to name a few. • First-hand experiences that fueled the passion for making a difference (e.g., seeing the difficulty that patients encounter in navigating the system, practicing in a rural area, etc.). • Losing a key position and learning from mistakes along the way. In other words, being willing to take risks, make mistakes and be vulnerable – to try, fail, learn and grow. • Mentoring by a respected physician or non-physician leader. • Coaching by an external coach. • DERAILERS • Being risk averse • Limited self-awareness • Inability to manage change • Being inflexible and/or impatient • Being too self-involved and individualistic • Being naïve about the importance of politics • Inability to persuade groups towards a common goal • Allowing the tactical to take the place of more strategic work • Unwilling to give up instant gratification for longer term success • Unclear role expectations for self and inability to communicate expectations to others METHODS FORMOREINFORMATION Tracy Duberman, Ph.D. Senior Vice President, Organizational Effectiveness Practice WJM Associates, Inc. 973.722.4480 tduberman@wjmassoc.com Leonard Fromer, MD, FAAFP Executive Medical Director Group Practice Forum 310-383-8168 LF@grouppracticeforum.com A qualitative, inductive, behavioral event interview design with psychometric testing to determine the key leadership behaviors of physician executives of large group practices, including physician CEOs and leaders of large multi-specialty stand-alone and integrated group practices spanning several regions in the United States. Participant organizations include Austin Regional Clinic, Clinical Care Associates of the University of Pennsylvania Health System, Dean Health System, Healthcare Partners Medical Group, Holston Medical Group, Medical Edge Healthcare Group, St. Vincent Physician Group; and advisors from Group Practice Forum, The Iowa Clinic, and TransforMED.