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Building Leadership Teams in Physician Organizations

Building Leadership Teams in Physician Organizations. A Case Study: Pediatric Health Care Alliance, P.A. (PHCA) - Tampa, FL October 2007. F. Lane France, M.D. Richard Ferrelli. Physician Leader, Medical Director - PHCA Founder - PHCA Founder - Pediatric Health Alliance, LLC (PHA)

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Building Leadership Teams in Physician Organizations

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  1. Building Leadership Teamsin Physician Organizations • A Case Study: • Pediatric Health Care Alliance, P.A. • (PHCA) - Tampa, FL • October 2007

  2. F. Lane France, M.D. Richard Ferrelli • Physician Leader, Medical Director - PHCA • Founder - PHCA • Founder - Pediatric Health Alliance, LLC (PHA) • Vice Chairman, Medical Director, Founder - iLIANT Corporation • Founder - KidsGrowth.com, LLC • Entrepreneur, Private Investor • Consultant to MED3000, PHCA, PHA • Founder and Chief Operating Officer - PHA • Founder and President - iLIANT Corporation • Founder and CEO - KidsGrowth.com, LLC

  3. Business Process Outsourcing for Medical Industry Pediatric Practice Management - 41 physicians - One of the largest pediatric groups in Florida and in the U.S.

  4. Physician Leader Development • Background • Initial Program Development Process • Initial Program Implementation • Evolution of Program • Finding a Leader becomes Developing Multiple Leaders

  5. Background • Dr. France is a historical physician leader & visionary (Medical Director) • Common occurrence – one main leader in a group • Determined leadership needs • Recognized need for a replacement for Dr. France • No clear successor with universal respect and standing among group • Job description for Medical Director • Develop a 1-year “training program” for successor • Internal vs. external candidates • Physician recognition that physician leadership is important

  6. Initial Program Development Process • Physician Input • Confidential survey asking opinions on potential Physician Leader / Medical Director • “Are you interested in becoming Medical Director?” • “Who would you recommend?” • “What are the most important qualities / characteristics / skills?” • Narrowing the candidate pool

  7. Initial Program ImplementationNarrowing Down Candidates Leads to Novel Program • Six candidates • Strengths & weaknesses in each candidate • No standout or universal choice • Difficult choice • Develop a program for ALL 6 candidates in order to have multiple doctors ready and to strengthen overall organization

  8. Initial Program ImplementationAdvantages of Multiple Doctors in Program • Create a cadre of leaders for group • Build business confidence throughout physician ranks • Give physicians a broader background in the business of medicine • Urge “silent” leaders to speak up with confidence

  9. Initial Program ImplementationMentoring Program – 6 Candidates Participating • Business Participation • Candidates visit business office once a week on a rotating basis, to participate in various business meetings and training: • HR • “Physician Issues” • Marketing • Finance • CBO Operations • Site Operations • EMR

  10. Initial Program ImplementationMentoring Program – 6 Candidates Participating • Leadership Mentoring • Candidates spend time with Dr. France in resolving specific physician issues, including: • Behavior • Productivity • Dress Code • Patient Relations • Partnership Issues

  11. Initial Program ImplementationMentoring Program – 6 Candidates Participating • Monthly Round Table Discussions • Outside Speakers (insurance industry, medical practice evolution) • Case Studies • Actual Practice Problem Resolution • Strategic Thinking • Changing Nature of the Practice of Pediatrics and Primary Care

  12. Initial Program Implementation • Survey senior business leaders and site staff • Confidential opinions of candidates • Confidential round tables • Feedback to candidates • Perceived strengths and weaknesses • Potential for “eye-opening” insights

  13. Important Features • Physician input and buy-in to process • Physician leadership • “Training period,” if possible • Multiple candidates • Specific time commitments • Compensation for time committed

  14. Important Features • Exposure to variety of business issues • Finance • Employee management • Physician management • Human Resources (staff and physician issues) • Technology Issues

  15. Important Features • National involvement and exposure • Business leaders involved in decision making • Senior site staff involved in decision making with direct feedback to candidates • Entire company buy-in

  16. Further Program Implementationand Development • Independent Preparation of Presentation • Given by each candidate in front of all shareholders • Strategic vision for practice • Future goals • Future of pediatrics as each candidate sees it • Assignment Preparations • Case study development and presentations

  17. Further Program Implementationand Development • Positive reaction to multiple leadership roles • Desire to continue building multiple candidates as leaders • Reduce worries of “one” leader issues • Desire to not “crown” a physician “king”

  18. Rethinking Leadership in a Stable and Growing Physician Group • Needs are different from a “crisis” situation • Mentoring process opened eyes to benefits of multiple leaders • All physicians more secure with multiple, educated, well-versed leaders • Stronger group dynamics with multiple leaders • Still a need for one or two overall leaders – “Management Team” approach

  19. Sets policy initiatives • Reviews and acts on recommendations from Medical Director and Administration • Final decision-making authority on PHCA-specific issues • Individual members involved in governance of policy implementation • Liaison • Quality • Education / Coaching • Primary responsibility to PHCA – secondary responsibility to MED3000 • Business functions for PHCA • Separate responsibility to MED3000 for profit initiatives and profit performance PHCA Board of Directors Administration (PHA / MED3OOO) Medical Director

  20. PHCA Board of Directors has become very active in decision making over the last two years as the practice has grown. • Board involvement must continue for the practice to continue to develop. The Board and Mentor candidates are a stable of knowledge and leadership for PHCA. • The Mentor Program has created broad leadership capability which must be actively used throughout the organization. • Mentor candidates and Board Members as a group should view themselves as the “leaders” of the PHCA organization. The Medical Director alone is not “the leader”.

  21. Medical Director role is very important, especially as a liaison between PHCA and Administration. However, the Medical Director role will not only be a leadership position, but also an important staff position which will be responsible for specific medical and business initiatives. The Medical Director should take direction from the Board of Directors while offering his/her own ideas, perspectives, and leadership initiatives. • Medical Director is a Chief Operating Officer-type position. The Medical Director leads, but policy is set by the Board of Directors, which should not relinquish its leadership status. The Medical Director is accountable primarily to PHCA Board, and secondarily to Administration/MED3000. • The Medical Director should have specific initiatives for which he/she should be accountable. These initiatives will be agreed on by PHCA Board and Administration/MED3OOO. • The Medical Director should not have a seat on the PHCA Board of Directors.

  22. An active Board of Directors, which leads and actively sets policy, will create a feeling of empowerment among physicians. This is important in the “growth and stability” phase of PHCA organization. • Committee structure must also remain strong and active. • It is important to continually spread leadership and knowledge to many PHCA physicians. • Continue and expand mentoring program as appropriate • PHCA President Role especially important as leader. In terms of leadership, it can be seen as interchangeable with Medical Director, although the Medical Director has additional “staff” functions. • Consider additional administrative fee for President • Need to view “leadership” as three parts of a management pie: • 1. PHCA Board of Directors • 2. Administration • 3. Medical Director

  23. Two-Year Rotating Terms for New Medical Director • New Medical Director chosen by approximately August 1, 2007 • First new Medical Director will have 2-year term • Similar to law firm models • Re-appointments OK • Half-time position to start • “Leadership team” with Board President and other candidates • Ongoing process review • Ongoing performance review

  24. Further Selection Process • Special committee of Board of Directors formed • Re-interview top staff and physicians for input on candidates • One-on-one interviews with final two candidates • Special committee recommendations to PHCA Board of Directors • Final Medical Director selection

  25. 2. Mentoring and development 3. Multiple leaders identified and groomed 4. Recognition of need to not “crown” a physician “king” 5. Comprehensive evaluation of mentoring candidates 6. Emergence of one or two leaders 7. Emergence of multiple proficient leaders to overall benefit of group 8. “Management Team” approach to leadership SUMMARY 1. Need for a leader

  26. Pediatric Health Care Alliance, P.A. QUESTIONS&DISCUSSION

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