Medical staff culture: A look back at a year of new medical staff models

It has been almost a year since The Greeley Guide to New Medical Staff Models: Contemporary solutions for today’s physician-hospital relationship challenges was published. The book was a direct response to a question asked by physicians and hospital CEOs over the past several years: In what direction is the medical staff moving?

The answer is based on The Greeley Company’s more than four decades of experience working with hospitals and medical staffs. We work with hundreds of hospitals, medical staffs, and other physician organizations across America and experience firsthand the challenges confronting hospitals and physicians. We also have the privilege to witness examples of outstanding leadership from physicians, hospital managers, and board members who are giving rise to a wide spectrum of experiments that examine how physicians and hospitals can align their interests and tackle the challenges facing healthcare today. This is where we derived the basis of our book.

The experimentation going on in the field creates a unique set of circumstances that can represent great opportunities for physicians and hospitals. To take advantage of these opportunities, hospitals and medical staffs should start by identifying which specific medical staff models best help achieve key goals. I encourage you to use the spreadsheet on the CD-ROM that accompanies the book to find out what models will best help your organization meet its most important goals.

As I look back on the past year, I’ve noticed that several common themes related to medical staff design have emerged, including: 

• Most hospitals are challenged by the task of managing multiple models simultaneously
• Experienced physician executives are a key ingredient for successfully implementing and managing multiple models
• Many more physicians, especially surgeons and medical specialists, are approaching organizations about employment arrangements, and hospitals need to be prepared to respond or risk losing those physicians
• Hospitalists programs continue to expand, meaning that the number of contract and employment arrangements are growing
• Telemedicine programs continue to expand and include imaging services, critical care, neurology, and others
• A number of gainsharing demonstration projects are continuing or being launched

Successful organizations are managing the chasm between physicians and hospitals by seeking alignment and integration wherever possible. Many are offering a “menu” of options, ranging from Stark-proof assistance to contract arrangements, joint ventures to full employment.

As with any change, physicians and leaders alike will respond with everything from outright rejection to abject acceptance. The successful management of this interface between physicians and hospitals requires knowledgeable leaders with excellent communication skills, experience in principled negotiation, and healthy doses of compassion and empathy.

Until next time, be the best that you can be.

William K. Cors, MD, MMM, CMSL, is the vice president of medical staff services at The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.