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Medical Staff Development - The Right Number

Truth-telling sounds pretty elementary. Most health care providers are truthful people. The problem as I see it is that most health care providers are so busy that they fail to recognize truth about themselves. Their focus is often on doing more and more. Knowing the truth about their professional goals requires time to reflect and ask the important questions about what gives meaning to the professional life. Though it is simply one example of the issue, establishing life balance in high performance professionals will significantly alter the calculation of what is the right number of physicians to have on the medical staff. Do we take the time to stimulate reflection? Do we encourage our caregivers to ask these key questions? Are the caregivers regarded as the engine of business or the healthy, balanced human beings that we want our own physicians to be? Is this care for the caregiver too expensive? Does it take too much time? Is it just not on the radar screen?

Medical Staff Development

Dr.William Cors, of the Greeley Company, begins his analysis of medical staff development by calling for the right number of physicians. The concept of the right number sounds incredibly simple, but the right number is the wrong number if the specialty mix is out of balance or if there is a gap in the 24 hour coverage. Truth-telling is critical as administrators and staff physicians explain their goals to each other. Truth-telling is much more likely to happen when the conversation isn't viewed as a part of a continuing negotiation, rather when the parties are working from a common mission. This is particularly so when a faith-based hospital mission is what they have in common and what resonates deep with their own purpose.

Medical Staff Development

I recently read James Londis' book, "Faith-Based Caregivers". There he asserts that "A true revolution in Christian health-care would result in patients experiencing the person of Jesus in the care they receive at our hands. Anything less cannot claim to be an heir to Christ's healing ministry." Developing a medical staff to provide that level of care while honoring its cultural and religious diversity requires us to think carefully, deeply and critically about what Christ's healing ministry actually signifies. This kind of thinking comes out of dialogue. What opportunities have we provided in the hospital that encourage that dialogue? How do we move to the point that patients experience that kind of care if we have not begun the dialogue?

Medical Staff Development

There are some earlier posts that bear on the issue of medical staff development. See February posts on "Mission" and "Barriers to Collaboration". Also January's post entitled "Challenges" shows some of the forces working against an alignment of physicians. Physician compliance with the hospital is different than alignment. When alignment occurs at the physician's "heart" level, impassioned collaboration results. The question is how to form the physician's heart. Embedded in that question is how do we need to form our own hearts.

Medical Staff Development

Medical staff development plans are predominantly medical staff selection plans. Medical staff development involves a dedicated and thoughtful effort for the entire time that a physician is on the medical staff. It involves a change of administrative paradigm. It involves moving from the question: "What can this physician do to build this hospital's business?" to the question: "What can we do to help this physician be a fulfilled healer?"

Medical Staff Development

Competition by specialists with hospital services can create friction, derail collaboration and has already passed the point of mission alignment. Competition is bred into our culture. It strengthens us and pushes us to higher quality, but at the cost of fractured relationships and duplication of services. With health care financing at the point of significant belt-tightening, neither the hospital nor the specialists can afford the battle. Much of the drive to compete is the spin-off of a spiritual battle raging within the competitors, the classic rift between pride and humility. Medical staff development, at its best, will address that very fundamental rift. It will be ready to take the time and make the personal effort. In the end it will be rewarded with a cohesive medical staff.

Medical Staff Development

A feature of most medical staff development plans includes an analysis of possible new clinical services. When medical staff development is focused on the bottom line, the choices of new services can provide some interesting and unusual options, a few of which prove profitable. That focus comes at a price. The remainder of the medical staff readily sees the motivation. Whether they articulate the observation or not, they certainly understand the administration's bottom line focus...and its implication that the mission, vision and values are important but take a back seat. Conclusion: The bottom line is important but belongs in the back seat. (Matthew 6:33)

Medical Staff Development

Integrating physicians into the mission of a hospital is the premier challenge in medical staff development. True integration involves more than the pledge-to-the-flag lip service that often substitutes for real commitment. True integration requires an alignment of the physician's passions. I think faith-based hospitals have an excellent opportunity here since their mission can resonate with physicians' own passions at a very deep level. It is so easy even in a faith based hospital to swing toward the business model of medicine. Our diversity provides further pressure away from faith-inspired medical healing. I favor dusting off those mission statements, having some thoughtful dialogue about what they really mean and breaking through some of the habits of the business model to achieve extraordinary physician integration.

Medical Staff Development

Since the 1980's hospitals have had medical staff development plans, some of which have been very controversial. One component of staff development involves the physician recruiting criteria. Most criteria revolve around issues in the medical market place. Ironically, the mission of most faith-based hospitals rarely includes a statement about earning a lot of money. Should not the criteria for physician recruitment also include the physician's commitment to the mission of the hospital? Should not faith-based hospitals recruit first for virtue then for economic qualities?