New Medical Executives Institute

1. New Medical Executives Institute Putting Together the Puzzle: Working with Physician Leaders D. Brent Mulgrew, JD, Executive Director, Ohio State Medical Association

2. Your Value • New Eyes and Ears • Different expectations • Personal attitudes and experiences • Not part of organization’s status quo • Desire to learn, at every level • Expectation of participation • Impatience

3. The Basics • Mulgrew’sRule #1—Friends! • If you want a friend, get a dog! • Rule #2—This isn’t their day job! • Rule #3---Physicians are different

4. Physicians are Different • Trained as the decision maker • Used to having problems brought to them • Like choices • Look for one solution and repeat it • Cannot make mistakes or show lack of knowledge • Trust advisors • Look for negatives Thomas Stearns, State Volunteer Insurance

5. Social/Leadership Issues • Very smart, president of chemistry club • Studied intensely throughout school, -social • Younger physicians are deeply in debt • Quality of life, family and social struggles • Older physicians are unhappy with their future • Relationship stress with other physicians • Relationships with the rest of the world

6. Association Leadership Resources • AAMSE • ASAE, CEO-Chief elected officer conferences • Assns. Now--Annual Volunteer Leadership Issue • Harvard Business Review • Local Association colleagues inindividual membership organizations-bar, cpa, etc. • Web Programs and personal volunteering • Local University classes--

7. Opportunities • We are blessed with a plethora of problems • More problems than time to solve them • What are the most critical issues in your area? • It’s up to you and your team to decide tactics • Strategic Leadership vs. Tactical Decisions • Is medicine a profession or a commodity? • Are physicians only units of labor?

8. Board Responsibilities • Determine mission, vision, purpose • Engage in strategic planning and “directioning” • Ensure fiscal management • Approve and monitor programs and services • Support Board decisions to constituents • Hire, evaluate and fire CEO

9. Critical Board Issues • The Board tries to manage rather than lead? • Are the cliques in control? • Do the officers/exec comm make all the decisions? • Are their undisclosed conflicts? • Does the board rubber stamp staff recs? • Does the board read your communications? • Are the expectations clearly identified and reinforced by the elected leadership?

10. Issues (cont.) • Is their a culture of commitment? • Is their an understanding of the finances? • Is staff input sought/respected? • Is their a formal leader development program? • Is there an annual evaluation of work? • Strategic plan, goals, objectives, metrics, etc.

11. Interpersonal Relationships • “Be sincere, be brief, be seated” T. Roosevelt • The discussion will fill the time available +5 • Never stand between two physicians disagreeing—they’ll both ---- on you • “Remember you are the ranchhand not the ranch owner”—Lou Goodman, TMA • “It’s their Association and their money”-HFP

12. Physician Board Culture • Identify the unique characteristics of your board’s culture…does your structure reflect it? • How do you perceive culture, react to it? • What are your board members expectations? • What is the staff role in the org’s culture? • Servant, info source , worker bee, equal? • Can, should the staff role be changed? By who?

13. Insight and Information • Physician’s Specialty • Previous work experience/type of practice • Current work environment/go see it • Possible issues in life and relationships • Present Expectations • Goals and Aspirations—why are they here? NMEI 2010

14. Personal Data • Data Sheets • “Favorites” Survey • Identifying Predispositions and Assumptions • About the organization/how it works • About the staff/how do they interact • About you/explain your role NMEI 2010

15. Meet the Council Survey • What is your favorite vacation spot? • What was the last book you read? • What is your favorite restaurant? • What is your motto in life? • What is your favorite sport / hobby? • What website do you visit most often? • What is your favorite music? • Who most influenced your career choice?

16. Leadership Programs • North Carolina, Virginia, Florida, California FPs • Nominating committee’s responsibilities • Slotted seats • Diversity • Efficiency vs Chaos • Students, Residents, Young Physicians, IMGs

17. Conversations and Questions • Are we on the right track to perceive, meet and exceed member needs and expectations? • Are there new opportunities we need to consider RIGHT NOW! • What are our unfilled skill, program and product needs? • Are we involving the members adequately? NMEI 2010

18. Today’s QuestionCan our traditional, geographically based, professional associationmembership model effectively respond to the needs of our members today and the members to be?

19. Association’s Assets Community of members with similar experiences Specialized content provider Credibility (BRAND) Community reputation Proven political power/visibility

20. Traditional Association Model exclusivity (members only) dues supported programs (subsidy vs. market pricing) hierarchy, structure and processes geographic boards, chapters and committees

21. The Opportunity of 2008-2011 • “No greater thrill than being shot at---and missed!” Churchill • Health system reform and SGR-opportunity? • Need leaders capable of adaptive leadership • Seize the opportunity within disruption • Use it to bring closure to the past • Change the rules • Redefine work, roles and products to respond

22. Lessons • Change Happens • Anticipate Change • Monitor Programs so you know when they’re stale • Adapt to Changes Quickly • Change the Services/Programs to meet the needs as redefined • Enjoy the change, because it will occur with or without you • Be ready to change again and again ”They keep moving the cheese”

23. Web Fall-out “Associations have lost their information franchise.”Bruce Butterfield, CEO, The Forbes Group

24. Web Fall-out All “the rules” are changing. Who will make the new rules and frameworks for programs and activities?

25. Web Fall-out ONLY INSPIRED, RISK-TAKING, ENTREPRENEURIAL LEADERSHIP WILL PREVAIL!

26. Today Professional/Individual member organizations are at a crossroads • Status quo is not viable • More competitors with better focus • Limited organization resources -(money & time) • Disappearing social/professional commitment

27. Associations cannot remain: Comfortable, capable, steady or stable and expect to survive!

28. Forget > Learn“The problem is never how to get new, innovative thoughts into your mind, but how to get old ones out.”Dee Hock

29. The definition of insanity:Doing the same thing over and over and expecting different results

30. Associations must become:Lean, Linked, Electronic & Malleable

31. Services must also become:Competitive Driven and Focused

32. Leadthe current members and move the organization to meet the needs of the members to be!

33. There are 2 Kinds of …Defense*vs.Offense***Fend off upstarts.**Reinvent our marketspace!

34. ACT NOW,ACT FAST, KEEP ACTING

35. “Strategy meetings held once or twice a year” to “Strategy meetings needed several times a week” Source: New York Times on Meg Whitman/eBay

36. “Reward excellent failures. Punish mediocre successes.”Phil Daniels, Sydney Exec

37. The greatest dangerfor most of us is not that our aim istoo high and we miss it,but that it is too low and we reach it.Michelangelo

38. ADAPT OR DIE Charles Darwin

39. If you do not change You can become extinct Spencer Johnson, MD

40. Where to go? What to do?:How do we improve The Institution to face these new challenges?

41. How do we adapt to face the new challenges while meeting our current mission?

43. Choosing our new Direction Can we become an organization that provides quick, easy access to custom designed services and information for physicians and their practices in the face of direct and unrelenting competition for their time, money and attention?

44. Gearing Up Internal Analysis • Gather input from elected leadership and staff • Examine the current mission statement and activities • Identify measures of effectiveness • Project long-term viability

45. Gearing Up A Consistent Complaint • Physicians are frustrated in their practices • Legislative advocacy is not enough to prevent frustration and resolve daily problems and challenges • Physicians do not see sufficient value in membership as it relates to their practice • Physicians are giving up their private practices to reduce hassles

46. Gearing Up A Consistent Request: “If I stay…” • Make practicing medicine less complicated and more satisfying • In addition to advocacy, provide assistance and training in practice management to me and my staff: • Billing and Collections • Personnel Issues • Legal • Clinical & Non-Clinical Education • Electronic Health records

47. “Every morning in Africa, a gazelle wakes up. It knows that it must run faster than the fastest lion or it will be killed. Every morning a lion wakes up. It knows that it must outrun the slowest gazelle or it will starve to death. It doesn’t matter whether you are a lion or a gazelle …”

48. “When the sun comes up, you had better be running.”