Posts From: Dr. Michael G. Cassatly

As a recap, the two previous blogs discussed the three choices of partners available to physicians to dance the ACA melody of healthcare reform: colleague physicians, healthcare delivery systems and patients. While the ideal partner in each of these groups must exhibit excellent communication abilities, the steps to the ACA dance are different depending on the choice of partners. As the dance steps for colleague physicians and healthcare delivery systems were previously discussed, this blog will look at the physician-patient dance.

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As discussed in the previous blog, there are three choices of partners for physicians to dance to the ACA melody of healthcare reform: colleague physicians, healthcare delivery systems and patients. With all three types of partners, physicians must possess excellent communication skills. However, the steps to the ACA dance are different depending on the physician’s dance partner.

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Now that the Supreme Court has upheld the constitutional validity of the Affordable Care Act, Obamacare is here to stay and it's time to begin "Doing The ACA." So, get up off the couch, grab your partners and strut on up to the dance floor. But before you do, make sure you have vetted your partners’ capabilities to do the steps to this dance. In this blog, we will discuss what qualities physicians should look for in a partner. In subsequent blogs, we will discuss the steps of the ACA dance.

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Recently, I presented a Team Building and Physician Leadership Program to a group of young physician leaders at a mid Atlantic State Medical Association Annual Meeting. The participants are what we, in the executive business coaching world, term "high potentials." These are individuals who not only strive to perform at a constantly higher level, but also consistently reevaluate their performance to help them do so. The program consisted of three segments: team building, individual personality assessments and a review of how physician leaders and functioning healthcare teams can thrive in healthcare reform.

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A money manager of a large fund mutual fund recently told me, “The words ‘Tax Reform’ simply mean that politicians want to take more money from someone.” This explanation of Tax Reform lead me to ponder exactly what do the words ‘Healthcare Reform’ mean? Applying the money manager’s logic, Healthcare Reform simply means the politicians want to take money from somone in healthcare. Ostensibly, this Heatlhcare Reform is presented under the guise of decreasing costs, but still the monies representing the decreased costs are coming out of someone’s pocket.

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Jackie, my nurse, sheepishly said, “I think I gave him Penicillin by mistake.” “You think or you know you gave him Penicillin?” I questioned. Reading her face, I knew the answer before she spoke. “I gave him Penicillin and I’m so sorry Dr. Cassatly.” I told her to call 911 and say we had a patient about to go into anaphylactic shock; the most severe life-threatening type of allergic reaction.

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For the second consecutive year, a pharmacist at the local CVS store administered my flu vaccine. The young man was pleasant, personable and courteous. The facility was clean and the whole process from registration to receiving the shot took less than ten minutes. The pharmacist mentioned that he has been administering more than 100 vaccines per shift. This comes as no surprise really, as my medical insurance company awarded me a $25 gift card for getting my flu shot from a pharmacist, and not my physician. This is the same store I buy gum, batteries and greeting cards.......just adjacent to the gas station where I fill up my car.

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A Chief Medical Officer (CMO) from a large hospital asked me to speak with a hospitalist physician who had received a patient complaint from a hospital administrator. Interestingly, the administrator had recently been a patient in the hospital and felt that this same hospitalist was rushed and preoccupied when making rounds. Furthermore, the patient administrator felt the physician did not fully answer his questions. In the past, similar complaints had been received about this same physician, resulting in lower than average patient satisfaction scores. For simplicity, let’s call this physician Dr. A.

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Recently I have been consulting with a large specialty practice in the Midwest that is being purchased by the regional medical center where the physicians admit most of their patients. Both parties, the physicians and the medical center, do not understand the other parties motives for entering into this new relationship and thus, are jeopardizing the success of the new venture. Before I show how executive business coaching can be beneficial in this situation, let’s take a look at why physician-hospital relationships are changing.

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The transition in healthcare from a fee-for-service payment model to one based on value-based-purchasing is driving the concurrent transition of physicians from clinicians to physician leaders. Just as there are fundamental differences between the two payment models, there are stark foundational contrasts between physician clinicians and leaders. Adding to the physician’s burden, they very often must fulfill both roles simultaneously. Let’s examine the differences between the two physician roles and then, look at how to help physicians successfully make the transition.

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