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At a time when hospitals are looking for ways to optimize their performance, a recent study suggests an association between physician-led hospitals and high performance ratings.
Among 1,859 hospitals that were analyzed in the specialties of cancer, digestive disorders, and heart surgery, physician-led hospitals scored more than 25% higher than did those with nonphysicians managers, averaging 8-9 points more in their hospital quality ratings, according to Amanda Goodall, Ph.D., a senior research fellow at the Institute for the Study of Labor, Bonn, Germany. She analyzed data from performance ratings for the top 100 hospitals as ranked by U.S. News & World Report in 2009.
Hospital quality points were awarded based on quality measurements including mortality rates, nurse staffing, physician decision making, the number of discharges, and availability of necessary technologies.
The fact that the number of physician-led hospitals has declined by 90% (from 35% in 1935 to 4% today) has contributed to the ailing U.S. health care system, according to Dr. Richard Gunderman of Indiana University, Indianapolis, who has written about physicians as hospital leaders (Acad. Med.2009;84:1348-51). One of the reasons our health care system "is in such sorry shape" is the fact that many of the chief executives of our hospitals and health care corporations see the hospital primarily as a business whose product happens to be health care, Dr. Gunderman said.
He added that the qualities of a good doctor and a good manager are closely linked. "Studying structure and function and using it to improve coordination and performance is second nature to physicians. We need to provide physicians opportunities to better understand the structure and function of hospitals and [other health care organizations], so that they can use that understanding to help hospitals perform better."
The change, Dr. Gunderman said, needs to come from within the medical school curriculum.
"The organizational dimension of medicine (as opposed to the molecular, cellular, and other dimensions) has been crowded out of the curricula of medical schools and residency programs," he said.
Although the idea of doctors as hospital chiefs may have support within the medical community, Dr. Goodall said, further analysis is necessary to assess the tangible effects of physician CEOs vs. a business manager.
It is unclear whether the
U.S. News and World Report rankings are related to physician leadership at the
top. Certainly, success in health care organizations is related to cultural
teamwork, and regardless of whom the captain might be, all team members need to
function within an environment of mutual respect.
Dr. Franklin A. Michota
I should also say that running
an organization with budgets in the hundreds of millions of dollars is not
something the average physician could do. In fact, contrary to the comments in
this piece by Dr. Gunderman, I would argue that the average physician’s
training does not lend itself well at all to physician management. This is precisely
why so many physicians today who are interested in management are seeking MBA
degrees.
Health care needs smart
physicians and smart business people at the helm working together. Physician
CEOs need to know their limits with respect to the business, and business leaders
need to know their limits with respect to the medicine When such health
teamwork exists, I doubt it really matters whether the CEO has an MD or DO
after the name or not.
Franklin A. Michota, M.D., is director of academic affairs in the
department of hospital medicine at the Cleveland
Clinic. He reported no relevant conflicts of interest.
It is unclear whether the
U.S. News and World Report rankings are related to physician leadership at the
top. Certainly, success in health care organizations is related to cultural
teamwork, and regardless of whom the captain might be, all team members need to
function within an environment of mutual respect.
Dr. Franklin A. Michota
I should also say that running
an organization with budgets in the hundreds of millions of dollars is not
something the average physician could do. In fact, contrary to the comments in
this piece by Dr. Gunderman, I would argue that the average physician’s
training does not lend itself well at all to physician management. This is precisely
why so many physicians today who are interested in management are seeking MBA
degrees.
Health care needs smart
physicians and smart business people at the helm working together. Physician
CEOs need to know their limits with respect to the business, and business leaders
need to know their limits with respect to the medicine When such health
teamwork exists, I doubt it really matters whether the CEO has an MD or DO
after the name or not.
Franklin A. Michota, M.D., is director of academic affairs in the
department of hospital medicine at the Cleveland
Clinic. He reported no relevant conflicts of interest.
It is unclear whether the
U.S. News and World Report rankings are related to physician leadership at the
top. Certainly, success in health care organizations is related to cultural
teamwork, and regardless of whom the captain might be, all team members need to
function within an environment of mutual respect.
Dr. Franklin A. Michota
I should also say that running
an organization with budgets in the hundreds of millions of dollars is not
something the average physician could do. In fact, contrary to the comments in
this piece by Dr. Gunderman, I would argue that the average physician’s
training does not lend itself well at all to physician management. This is precisely
why so many physicians today who are interested in management are seeking MBA
degrees.
Health care needs smart
physicians and smart business people at the helm working together. Physician
CEOs need to know their limits with respect to the business, and business leaders
need to know their limits with respect to the medicine When such health
teamwork exists, I doubt it really matters whether the CEO has an MD or DO
after the name or not.
Franklin A. Michota, M.D., is director of academic affairs in the
department of hospital medicine at the Cleveland
Clinic. He reported no relevant conflicts of interest.
At a time when hospitals are looking for ways to optimize their performance, a recent study suggests an association between physician-led hospitals and high performance ratings.
Among 1,859 hospitals that were analyzed in the specialties of cancer, digestive disorders, and heart surgery, physician-led hospitals scored more than 25% higher than did those with nonphysicians managers, averaging 8-9 points more in their hospital quality ratings, according to Amanda Goodall, Ph.D., a senior research fellow at the Institute for the Study of Labor, Bonn, Germany. She analyzed data from performance ratings for the top 100 hospitals as ranked by U.S. News & World Report in 2009.
Hospital quality points were awarded based on quality measurements including mortality rates, nurse staffing, physician decision making, the number of discharges, and availability of necessary technologies.
The fact that the number of physician-led hospitals has declined by 90% (from 35% in 1935 to 4% today) has contributed to the ailing U.S. health care system, according to Dr. Richard Gunderman of Indiana University, Indianapolis, who has written about physicians as hospital leaders (Acad. Med.2009;84:1348-51). One of the reasons our health care system "is in such sorry shape" is the fact that many of the chief executives of our hospitals and health care corporations see the hospital primarily as a business whose product happens to be health care, Dr. Gunderman said.
He added that the qualities of a good doctor and a good manager are closely linked. "Studying structure and function and using it to improve coordination and performance is second nature to physicians. We need to provide physicians opportunities to better understand the structure and function of hospitals and [other health care organizations], so that they can use that understanding to help hospitals perform better."
The change, Dr. Gunderman said, needs to come from within the medical school curriculum.
"The organizational dimension of medicine (as opposed to the molecular, cellular, and other dimensions) has been crowded out of the curricula of medical schools and residency programs," he said.
Although the idea of doctors as hospital chiefs may have support within the medical community, Dr. Goodall said, further analysis is necessary to assess the tangible effects of physician CEOs vs. a business manager.
At a time when hospitals are looking for ways to optimize their performance, a recent study suggests an association between physician-led hospitals and high performance ratings.
Among 1,859 hospitals that were analyzed in the specialties of cancer, digestive disorders, and heart surgery, physician-led hospitals scored more than 25% higher than did those with nonphysicians managers, averaging 8-9 points more in their hospital quality ratings, according to Amanda Goodall, Ph.D., a senior research fellow at the Institute for the Study of Labor, Bonn, Germany. She analyzed data from performance ratings for the top 100 hospitals as ranked by U.S. News & World Report in 2009.
Hospital quality points were awarded based on quality measurements including mortality rates, nurse staffing, physician decision making, the number of discharges, and availability of necessary technologies.
The fact that the number of physician-led hospitals has declined by 90% (from 35% in 1935 to 4% today) has contributed to the ailing U.S. health care system, according to Dr. Richard Gunderman of Indiana University, Indianapolis, who has written about physicians as hospital leaders (Acad. Med.2009;84:1348-51). One of the reasons our health care system "is in such sorry shape" is the fact that many of the chief executives of our hospitals and health care corporations see the hospital primarily as a business whose product happens to be health care, Dr. Gunderman said.
He added that the qualities of a good doctor and a good manager are closely linked. "Studying structure and function and using it to improve coordination and performance is second nature to physicians. We need to provide physicians opportunities to better understand the structure and function of hospitals and [other health care organizations], so that they can use that understanding to help hospitals perform better."
The change, Dr. Gunderman said, needs to come from within the medical school curriculum.
"The organizational dimension of medicine (as opposed to the molecular, cellular, and other dimensions) has been crowded out of the curricula of medical schools and residency programs," he said.
Although the idea of doctors as hospital chiefs may have support within the medical community, Dr. Goodall said, further analysis is necessary to assess the tangible effects of physician CEOs vs. a business manager.