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James A. Greer, Jr., MD, MBA Medical Director Ochsner Clinic Foundation Baton Rouge. Medical Profession. Ethics Law Business Administration. Healthcare Trends. Changing Patient Demographics Changing Workforce Consumerism Technology Genetics Quality Patient Safety Tort Reform
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James A. Greer, Jr., MD, MBAMedical DirectorOchsner Clinic FoundationBaton Rouge
Medical Profession • Ethics • Law • Business Administration
Healthcare Trends • Changing Patient Demographics • Changing Workforce • Consumerism • Technology • Genetics • Quality • Patient Safety • Tort Reform • Baby Boomers Impact • Uninsured Population • Insurer Consolidation • Specialty Hospitals
Local Market Trends • Charity System • Medicaid Funding • Physician Competition with Hospitals • Specialty Hospitals
Resources • Manpower • Materials • Machines • Money • Methods • Marketing
Group Practice Tasks • Physician Manager • Administration • Tasks of Both
► Doers ► Planners, Delegaters Clinicians Managers ► 1:1 Interactions ► 1:N Interactions ► Reactive Personalities ► Pro-Active Personalities ► Deciders ► Expect Delayed Results ► Value Autonomy ► Value Collaboration “My Judgment” “Our Team” ► Patient Advocate ► Organization Advocate ► Tolerates System ► Committed to System ► Authority of Knowledge ► Authority of Position ► Resents Rules ► Promotes Rules ► Optimizes ► Controls “What is best?” “What will do?”
Physician Manager Tasks • Maintaining Quality • Innovative Adequate Work Effort • Retention • Adequate Compensation Plan • Recruitment • Personnel Issues • Dealing with Exceptional and Problem Physicians • External Relationships • Developing Future Leaders
Tasks of Physician Manager and Administrator • Customer Satisfaction • Strategic Direction • Marketing • Communication • Fee Schedule • Allocation of Resources • Culture of Group
Personnel Issues/Physicians • Evaluations • Patient Satisfaction, Competence, Relationships, Practice Data • Impaired Physicians • Medically Incompetent, Personality Problems, Substance Abuse, Sexual Misconduct • Physician Management of Non-Physician Personnel
Physician Compensation • Allocation for Physicians • Payout vs. Retained Earnings • Allocation to Physicians • How to Distribute? • Gross Charges, Revenue, RVU’s, Equal Distribution, Other • Subjective Components
Strategic Planning • What’s the future and how do we get there? • Growth • Natural or Planned? • Capital Needs • Planning • Changes • Branches
Information Systems • Cost • User Friendly • Flexible • Integrated Database • Easy to Maintain
Information Systems • PACS • EMR
Managing Professionals • Realize Peer Pressure • Sell Input • Use Facts/Knowledge • Communicate the “Big Picture”
The Business Plan • Executive Summary • Market Analysis • Company or Group Description • Organization and Management • Marketing Plan • Service or Product Line • Funding Request • Financial Statement • Appendix
Challenges • Managing the Professionals • Managing the Cost/Q Tension • Positive and Negative Interactions • Balance of “Physician & Manager” • Advocate of both Physicians and Organization
Lessons Learned • Practice Medicine • Assume People Will Do Their Best • Persuade, Not Dictate • Prepare for Meetings • (Over) Communicate • Relationships & Colleagues • 1st: Patients • 2nd: Organization • 3rd: Individual • Involve Physicians with Decisions • They always raise issues • Satisfaction is Different