David O. Parrish, MS, MD, FAAFP Bayfront Family Medicine Residency

Why do we have to change? Current status of Healthcare Leadership The Physician Executive Leadership training (in medical education) Business management training (in medical education) How do you break down the silos (in medical education) with respect to business and leadership training? A pathway forward

Institute of Medicine’s Crossing the Quality Chasm Report 1 Skyrocketing health care costs 2 Management of health care resources 3 Sources: 1. Quality-Initiative.aspxhttp:// Quality-Initiative.aspx

Most hospital CEOs hold a degree in Masters of Hospital or Healthcare Administration 1 Types of Experience: Strategic management, business leadership, executive leadership 1 Physician CEOs: 235 out of 6,500 hospitals within US 2,3 Sources: nytimeswellhttp://well.blogs.nytimes.com/2011/07/07/should-hospitals-be-run-by-doctors/?seid=auto&smid=tw- nytimeswell

Who are they? 1,2,3 Board-Certified MDs/DOs What do they do? 1,2,3 a. Provide administrative direction to the health care organization’s organized Medical Staff b. Guide the Medical Staff towards the goals of the health care organization c. Provide administrative direction of the health care organization Sources: 1. omain=HHNMAGhttp:// omain=HHNMAG

A formal longitudinal pathway of leadership and business training for physicians is needed Usually undertaken by “seasoned” practicing physicians On the job +/- formal business & leadership education

The Joint Commission The Accreditation Council for Graduate Medical Education Liaison Committee on Medical Education Limited requirement for leadership training for practicing physicians, physicians-in-training, or medical students, yet they are increasingly being evaluated on “Interpersonal and Communication Skills” and “ Professionalism”. In addition, as they progress in levels of their educational training they are being placed into leadership roles in their respective communities, health care organization, and health care associations due to their expertise.

The Joint Commission The Accreditation Council for Graduate Medical Education Liaison Committee on Medical Education Limited expectations for business management education for practicing physicians, physicians-in-training, or medical students, yet they are increasingly being evaluated on “system- based practice” and managing healthcare costs.

Can be a physical impediment, however, more so an organizational and/or individual mind-set that results in the unwillingness to share or participate in a cross system manner that will benefit the overall ecosystem in which the organization and/or individual operates within. Source: Lencioni, Patrick. “Silos, Politics and Turf Wars: A Leadership Fable About Destroying the Barriers That Turn Colleagues Into Competitors”

Accreditational: The Joint Commission vs. ACGME vs. LCME Institutional: Inpatient vs. Outpatient Leadership: Senior Management vs. Middle Management

Willingness of industry leaders to break silos Working across the ecosystem of health care to develop an enhanced framework of medical education and training as it relates to business education and leadership training Measuring the change and “flexing” with the results

“Un-Siloed” Framework for the Development of the Next Generation of Physician Executives Start as early as possible to explain, discuss and teach not only interactive leadership skills, but the coordinated business expectations.