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    Nick Fabrizio
    Nick Fabrizio, PhD, FACMPE, FACHE

    The healthcare market continues to evolve as it has in recent years. Instead of the traditional hospital/medical group/insurance company triangle, new players and initiatives have entered the field and changed the game. Accountable care organizations (ACOs), cost reduction programs, population health, pay-for-performance (P4P), digital transformation, power shifting to payers and consumerism have transferred more responsibility to physicians, requiring them to be active participants in managing the organization. 

    In this new environment, physicians must be more involved in their organization’s leadership and operations. This means that physicians must be willing, able and qualified to serve on various committees in their organizations. Regardless of the work setting — private practice or hospital system — physicians will have new responsibilities in monitoring the costs, quality, outcomes and productivity of their organizations.
    During the past 10 years, many of my clients (private medical groups) have decided to sell their practices, in part to relieve themselves of the burdens of running a medical group. In today’s healthcare marketplace, it is increasingly important for physicians not to abdicate their duties as leaders. Physicians play the most important role in healthcare: caring for and treating patients. The truth is that the healthcare marketplace cannot function unless physicians are at all levels of the pyramid.

    In the private practice world, physicians’ time in serving on committees is a cost of doing business and usually comes at the expense of revenue-generating activities. In an integrated environment, physicians must be compensated in some way for allocating their time to serve on key committees, which in turn helps hospitals and health systems achieve their business-related goals (such as P4P programs, quality initiatives, ACOs, shared savings programs).

    Best practices dictate that key committees will help the organization to effectively plan, control and monitor the complexity of inpatient and outpatient activities in a coordinated manner.  While members of an organization’s board of directors are required to fulfill their fiduciary duties and responsibilities, these leaders rarely have the time and expertise to grasp how important physicians are to the overall health of the organization. 

    There are a few requirements to having physicians serve on committees. The first is finding enough physicians who are interested and able to serve. I have seen numerous organizations that have had the same two or three physicians serve on multiple committees year after year. This can lead to burnout, take physicians away from patient care or make it difficult to groom other physician leaders. 

    Next, the organization must find the right committees for physicians to serve on. To successfully lead today’s organizations, physicians should serve in leadership roles on committees beyond the quality committee. Physicians must play key roles in overall system or group governance — with the parent board, operations, information technology, business development and marketing. 

    Some of the questions to address when placing physicians on committees include:
    • Is there a job description for each committee?
    • If the committee is project-based, will the role end once the project is completed?
    • Does the committee chair have clearly defined duties and responsibilities?
    • Are committee meeting minutes recorded?
    • Are committee meetings well-attended? Are members required to attend a specific number of meetings per year?
    • Is there a process to select, evaluate and educate committee members?
    • Is there a process to recruit and train future committee members?
    • Is committee performance evaluated?

    Creating key committees with physician representation is a hallmark of an effective organization. Integrating physicians on an organization’s committees will help ensure that the organization provides the structure to thrive in today’s healthcare market.
    Nick Fabrizio

    Written By

    Nick Fabrizio, PhD, FACMPE, FACHE

    Nick A. Fabrizio, PhD, FACMPE, FACHE, is a consultant with the MGMA Health Care Consulting Group. He has more than 20 years of practice management and health system experience in private physician and large medical group practices, for-profit and non-profit hospitals and health systems, academic medical centers, physician faculty practice plans and ambulatory care networks. His primary expertise is in physician practice management and managing complex physician-hospital relationships.

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