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[David Joyce MD, MBA]

Describe the leadership style in an organization in which you were a member.  How would you characterize the leadership style?  Did it work?

• This topic was modified 3 years, 9 months ago by David Joyce MD, MBA.

[David Joyce MD, MBA]

The executive see the world in a business framework.  Physicians see the world in a human framework.  Executive will never ever have a chance to care for patients.  But you can gain a working knowledge of business.  It is up to us to share our experience in the front lines in the language of business.  Strategy discussions, resource allocation, practice improvement activities initiated by those of us who see patients every day and conducted under a business framework is the best way to bring what you do every day to those who will never know what it is like to care for patients.  You will come out of the other end of this program with a new language new mind set.  Imagine if all of your colleagues had the same.  I can only imagine the power of that.

[David Joyce MD, MBA]

Kara Hawkins

Participant

The leadership style of our community hospital, now owned by a larger corporating, leans toward top-down,  unidirectional communication and authority. Similar to what the first provider noted, in order to save money, a more centralized approach to patient flow processes has been implemented at the expense of the community connection and feel of a smaller hospital/practice.

So, how does a community hospital maintain a small town feel when a large corporation has taken over? How can we provide the same individual care to our patients that doesn’t feel like the assembly line care the executives demand?

• This reply was modified 3 years, 9 months ago by David Joyce MD, MBA.

[Kara Hawkins]

The leadership style of our community hospital, now owned by a larger corporating, leans toward top-down,  unidirectional communication and authority. Similar to what the first provider noted, in order to save money, a more centralized approach to patient flow processes has been implemented at the expense of the community connection and feel of a smaller hospital/practice.

So, how does a community hospital maintain a small town feel when a large corporation has taken over? How can we provide the same individual care to our patients that doesn’t feel like the assembly line care the executives demand?

[David Joyce MD, MBA]

Wow!!  Clearly a major leadership deficit in that organization.  The negotiation course, the last in the program, addresses sizing up an organization and deciphering its culture among other things.  I am so sorry that happened to you.  I can’t imagine how vulnerable you felt at that point in your pregnancy.  One thing for sure, as a woman physician, you have learned to be more competent than most and tougher too.  I sense that you recovered from that insult and moved on.  This program will deliver some ammunition to fight poor leadership in the unemotional cool language of business.  Thanks for being in this class.

[David Joyce MD, MBA]

Hema Jonnalagadda

Participant

I worked for a huge reputed healthcare system out od residency and then for 2 other smaller healthcare systems – I never had a meeting where I thought they are really asking our input to improve patient care. They already made decisions and informed us that they will be implemented. Sometimes department heads were not involved in the decision making process as well.

I was 34 wks pregnant and was asked to add 2 more shifts to my weekly schedule ( 20 pts each) ( probably they are trying to make up for my future revenue loss when I go on maternity). But when I politely declined to add and said will do it when I return back, they termininated my contract for clinical competancy reasons when I was 36 wks pregnant…..(not sure why thye were not worried about clinical competancy when asked me to see more patients……..

• This reply was modified 3 years, 9 months ago by David Joyce MD, MBA.

[Hema Jonnalagadda]

I worked for a huge reputed healthcare system out od residency and then for 2 other smaller healthcare systems – I never had a meeting where I thought they are really asking our input to improve patient care. They already made decisions and informed us that they will be implemented. Sometimes department heads were not involved in the decision making process as well.

I was 34 wks pregnant and was asked to add 2 more shifts to my weekly schedule ( 20 pts each) ( probably they are trying to make up for my future revenue loss when I go on maternity). But when I politely declined to add and said will do it when I return back, they termininated my contract for clinical competancy reasons when I was 36 wks pregnant…..(not sure why thye were not worried about clinical competancy when asked me to see more patients……..

[David Joyce MD, MBA]

Katie Humphries

Participant

I recently left a hospital-owned practice, of which I had been a part since 2014.  Originally, we were owned by a community hospital, where the leadership was by physicians and by committee.  A large university system acquired the community hospital, and therefore, our practice, 18 months ago.  The leadership style of the new system was top-down and largely administrative/executive rather than physician-led.  The new hospital immediately implemented major changes into the highly profitable, highly functional neighborhood practice we had built from the ground up such as removing all incoming calls to the office and filtering them through a poorly functioning call center that serviced the entire hospital system.  Our patients were furious, as they could no longer reach the familiar people of the office AND had to be scheduled by the call center, who struggled to understand the difference between urgent (same day), chronic disease management and preventative visits.  They often got replies to their request for sick visits like “Dr. Humphries can see you in 3 weeks for this”.  As you can imagine, this was infuriating for patients.  My partners and I went directly to the top of the leadership board and pleaded with them to take our advice and allow the practice to go back to some old ways that had been developed specifically for the community in which the practice existed and with the community members in mind.  The answer was repeatedly “no” and “there will always be new patients, so don’t worry about the old ones”.  After getting nowhere, and taking on an enormous amount of intense patient complaints and poor internet reviews, all three of us decided to leave the practice together.   At no point did the leadership make any effort to meet with us, to understand our needs and the needs of the patients to whom WE were providing direct care for quite a long time.

This leadership style simply did NOT work for a small, neighborhood primary care practice.  The previous leadership, given their community focus and management by a primary care physician, believed that each practice in the physician group required slight differences in operations. We met monthly with the VP (a primary care physician), the financial team, and our elected physician leader to discuss practice management.  Our voices were all that mattered as they believed we spoke for the patients (demonstrated by the fact that we had an extremely profitable PC practice—a rare entity in the hospital-owned practice world).   We had a striking percentage of new patients on a monthly basis and these new patients were acquired by word of mouth from our current patients.  Our VP said every single time that the practice existed to serve the community, and that, as members of the community ourselves, we knew better than anyone else.  They listened to the needs and recommendations of our staff and our retention rate was 100% for 4+ years.  We knew who was in charge and who made decisions, but we also knew that these decisions were being made 1) on behalf of us and our staff and 2) to benefit our patients.  Perhaps it just takes a primary care physician to understand proper leadership and management of a primary care practice, but this inclusive and empathetic leadership-style worked so much better than the top-down governance style of the new hospital system.

[Katie Humphries]

I recently left a hospital-owned practice, of which I had been a part since 2014.  Originally, we were owned by a community hospital, where the leadership was by physicians and by committee.  A large university system acquired the community hospital, and therefore, our practice, 18 months ago.  The leadership style of the new system was top-down and largely administrative/executive rather than physician-led.  The new hospital immediately implemented major changes into the highly profitable, highly functional neighborhood practice we had built from the ground up such as removing all incoming calls to the office and filtering them through a poorly functioning call center that serviced the entire hospital system.  Our patients were furious, as they could no longer reach the familiar people of the office AND had to be scheduled by the call center, who struggled to understand the difference between urgent (same day), chronic disease management and preventative visits.  They often got replies to their request for sick visits like “Dr. Humphries can see you in 3 weeks for this”.  As you can imagine, this was infuriating for patients.  My partners and I went directly to the top of the leadership board and pleaded with them to take our advice and allow the practice to go back to some old ways that had been developed specifically for the community in which the practice existed and with the community members in mind.  The answer was repeatedly “no” and “there will always be new patients, so don’t worry about the old ones”.  After getting nowhere, and taking on an enormous amount of intense patient complaints and poor internet reviews, all three of us decided to leave the practice together.   At no point did the leadership make any effort to meet with us, to understand our needs and the needs of the patients to whom WE were providing direct care for quite a long time.

This leadership style simply did NOT work for a small, neighborhood primary care practice.  The previous leadership, given their community focus and management by a primary care physician, believed that each practice in the physician group required slight differences in operations. We met monthly with the VP (a primary care physician), the financial team, and our elected physician leader to discuss practice management.  Our voices were all that mattered as they believed we spoke for the patients (demonstrated by the fact that we had an extremely profitable PC practice—a rare entity in the hospital-owned practice world).   We had a striking percentage of new patients on a monthly basis and these new patients were acquired by word of mouth from our current patients.  Our VP said every single time that the practice existed to serve the community, and that, as members of the community ourselves, we knew better than anyone else.  They listened to the needs and recommendations of our staff and our retention rate was 100% for 4+ years.  We knew who was in charge and who made decisions, but we also knew that these decisions were being made 1) on behalf of us and our staff and 2) to benefit our patients.  Perhaps it just takes a primary care physician to understand proper leadership and management of a primary care practice, but this inclusive and empathetic leadership-style worked so much better than the top-down governance style of the new hospital system.

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