• What is the CPE?
• How was it established?
• What are the requirements for completing the CPE?
• How costly is the CPE to obtain?
• Is a management degree required?

Photo by rawpixel.com on Unsplash

Before proceeding, I want to spend a minute talking about the American Association for Physician Leadership. I’m not an affiliate and receive no compensation for this endorsement. But I’ve been a proud member of the AAPL for about 25 years, because it’s an outstanding organization.

It helps to support and promote physicians as managers, executives and leaders. Its members work in government; health, life and disability insurance companies; hospitals and health systems; medical groups; pharmaceutical companies; and anywhere physicians are employed.

The AAPL provides live conferences, online education, books, coaching, mentoring, career services and nonclinical job postings. It also provides physician executive certification, the CPE, that demonstrates expertise and skills as a physician leader.

I’ve mentioned the AAPL in numerous podcast episodes and interviewed the Director of Career Services, Dian Ginsberg, in Episode 24.

It truly is the world’s leading organization of emerging and established physician leaders. The cost of annual membership is a little less than $300.00 per year, which is a ridiculously low price. I strongly recommend you consider joining. Check It out using this link – vitalpe.net/aapl – to find out more.

Now, let’s get to today’s presentation.

Speaking of the AAPL, I'm often asked by physicians considering a management career about the CPE program. Is it worth the effort to complete? Is it better to get a business degree or the CPE?

Most of the information that follows is from the web sites of the American Association for Physician Leadership (or AAPL) and the Certifying Commission on Medical Management (or CCMM). I’ll provide my personal comments about the CPE at the end of this discussion. I’ll summarize the three reasons to pursue the qualification.

But these comments are my own. I do not represent, nor speak for, the CCMM or the AAPL.

What Is The CPE?

First, let me answer this question: What exactly is the CPE?

It’s both a program and a certification that physician leaders can obtain through a formal educational and experiential process.

According to comments I’ve heard from AAPL leaders, there was a desire 25 or 30 years ago at the AAPL (which was then called the American College of Physician Executives), to create some type of certification that would demonstrate the expertise in management and leadership.

There were efforts to create a board certification, possibly under the auspices of the American Board of Medical Specialties. When it became clear that such a certification in these nonclinical skills would not fit into the ABMS model, the AAPL leadership ultimately created the CCMM as a semi-independent entity to develop and administer certification as a physician executive, and the CPE program was born.

The AAPL is now celebrating the 20th anniversary of the CPE this year. To date, about 3,000 physicians have completed all of the requirements, and successfully attained the CPE designation.

Let's look at the requirements in more detail.

Professional Status

The first major requirement has to do with professional status. This means that you must have completed medical school training, be licensed to practice medicine, have at least three years of practice experience, and are board certified. That’s the basic starting point.

Education

The second major component are the educational requirements. This can be met by completing a management degree, such as an MBA, MMM, MHA, or MS in management. The alternative to a master's degree, is to complete the educational the required courses of the core curriculum through the AAPL.

Let me list some of the coursework that would be required if you don’t have a master's degree. The CCMM requires education in the following FOUR broad categories:

• Fundamental
• Developmental
• Experiential, and
• Transformational

The Fundamental Category includes courses addressing communication, finance, Influence, quality and negotiation.

The Developmental Category includes Managing Physician Performance and 2 electives running about 4 hours each.

The Experiential Category includes additional education in quality, accounting and high reliability, along with another 2 electives.

The final Educational Category, Transformational, consists of courses addressing financial decision-making, health law, conflict resolution and change management.

Leadership Experience

The next major requirement is one year of leadership experience. Each applicant must detail their leadership experience in a one-page narrative that is submitted to the CCMM for review. According to the website, the following are the areas that they ask the applicant to specifically address to demonstrate leadership experience.

• Talent management such as performance evaluations, determining salaries, hiring and firing of immediate staff, direct oversight over other physicians
• Data management (what data do you gather and how do you use it?)
• Fiscal responsibilities (managing your budget)
• Organizational impact (project implementation, managing up the chain, deal with stakeholders, etc.)

Capstone

The final component to the CPE completion is what has been called the CPE Capstone. This is a three-and-a-half-day program designed to provide additional education and to hone and assess your skills. It culminates in the presentation of a CPE leadership summary presentation. This presentation allows you to briefly and succinctly communicate how you have demonstrated your ability as a physician leader according to the CCMM website.

During the capstone, you'll be working with a cohort of other physicians and that large cohort will be broken down into teams. You will work with your teammates and often develop long-term relationships that persist beyond the completion of the capstone event.

So, what does that mean?

According to the AAPL, this certification has become the benchmark for CEOs and recruiters seeking the most accomplished and influential healthcare leaders.

As I look at job postings on LinkedIn and other job sites, I'm starting to see the CPE mentioned on an increasingly regular basis. Recruiters and hospital medical group leaders understand that if a physician has the CPE designation, then he or she has experience as a leader, has completed foundational education in management and business concepts, and has demonstrated a commitment to continuous learning in healthcare management.

Costs

Let’s talk about the cost.

The cost for the AAPL educational components basically run about $100 per hour of study. For the 150 hours of coursework, it's going to run about $15,000. Most physicians complete the coursework over a period of three to five years or more.

That's quite a bit less than the cost of an MBA, which would generally cost from $30,000 to $80,000, as was discussed in Episode #25. The capstone runs $3,650, which includes the $150 application fee.

You can learn more out the specifics by going to vitalpe.net/aapl or to ccmm.org.

3 Reasons to Pursue the CPE Qualification

Here are the three major reasons to complete the CPE:

Reason #1

If you wish to pursue a management or administrative career, this structured program will ensure that you'll have the basic attitudes, education, experience and communication skills to succeed in almost any such role.

Reason #2

The CPE credential demonstrates to employers that you have attained a high level of management education and experience with core competencies in key leadership areas, and superior communication skills.

I've noticed lately that many job postings for a hospital or medical group executive list the CPE designation as something that they're interested in seeing. And I believe that it provides a competitive advantage when seeking a high-level leadership position in any healthcare organization.

Reason #3

You will develop lifelong relationships with your CPE instructors and cohort members, that may well become useful later in your career.

I completed the CPE in 2012, and I think that I benefited primarily through the coursework that I completed, although I already had the master's in public health. It's hard to separate the networking and other support of the AAPL membership from the work done to complete the CPE. But, in general, it was a very positive experience and it ensured that I had the requisite background in finance, communication, negotiation, and so forth that I drew upon as CMO for my health system.

I found the capstone to be a very worthwhile experience. It may have changed since I completed it six years ago. A team of eight of us worked together, after some introductory lectures to the larger group.

We had homework to complete each night of the course, and several group activities. Then, we role-played interviews and difficult conversations with a disruptive colleague. Finally, we were videotaped and received feedback, both from our partners, and from the facilitator for our small group.

So, it is something that I would definitely recommend for anyone thinking about pursuing a career in leadership, whether it's with a medical group, an insurance company, a hospital, or any other large organization.

CPE vs. MBA?

The question about whether to get an MBA or complete a CPE is not really the right question. The real question is whether to obtain the business degree, or rely on the AAPL course work.

I believe that is a personal choice. It depends on financial considerations, your access to an appropriate degree program, the urgency of your desire to complete the CPE, and perhaps your learning style.

In my opinion, the required AAPL course work is basically equivalent to an MBA. So, either choice will work.

Thoughts on Leadership Experience

When I'm coaching physicians who are thinking about moving into an executive career, I use the CPE as a model for the physicians looking to make the transition, because if you think about it, the CPE does indicate the basic requirements for an effective physician leader.

To me the leadership experience component is probably the most variable and potentially confusing part of the journey.
Such leadership can be formal or informal, in a volunteer or paid position. It can be part-time, or full-time. And it might be independent or supervised.

Let me provide some examples.

Serving as a member of a nonprofit board can be useful leadership experience. But serving as the chair of that board will provide much more meaningful leadership experience.

Working on a hospital quality committee can be instructive. But chairing the committee provides deeper leadership experience.
Running a small practice or working in an entrepreneurial role provides some degree of leadership experience. But it is unsupervised and lacks direct feedback.

Working as a medical director within a larger organization, with an annual budget and formal reporting relationships, is more likely to provide real world leadership experience than the unmanaged experiences of the solo practitioner.

In summary, I think applying for and completing the CPE is a very worthwhile plan. Whether you obtain a formal management degree or obtain the business and management education through AAPL courses, the CPE program formalizes the process needed to obtain all the necessary education and experience to effectively function in a leadership position in most organizations. And there’s evidence that prospective employers recognize the value of the CPE when comparing applicants.

I hope you enjoyed today’s episode. If so, open your podcast app or go to iTunes and leave a review.

Join me next week for another episode of Physician Nonclinical Careers.

Resources

The resources mentioned in this episode are linked above.

Right click here and “Save As” to download this podcast episode to your computer.

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

If you'd like to listen to the premier episode and show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001

The post 3 Reasons to Pursue the CPE Qualification – 033 appeared first on NonClinical Physicians.

Free Career Transition Guide

Before I jump into today’s content, I need to tell you about a new “how-to-guide” I’ve written. It’s a 24-page manual, complete with checklists for 5 nonclinical careers. It outlines the steps you can take to pursue a career in utilization management, clinical documentation improvement, informatics, medical writing, and hospital management as VP for Medical Affairs.

I wrote it based on my personal experiences, and what I’ve learned doing interviews for this podcast. I was thinking of selling it on Amazon as a Kindle Book. But for now, it’s completely FREE for listeners to this podcast. To download your copy, just go to Free Career Guide.

A Listener's Question

I was on a phone call the other day, talking with a physician listener interested in exploring a new career. She was working as a gastroenterologist in a fairly large medical group and had become involved in quality initiatives at her local hospital.

Let’s call her Nina.

She didn’t have a formal leadership role in the hospital or medical group, but she really enjoyed working on quality improvement projects. And she wanted to explore a career in quality improvement.

She was thinking that she might ultimately want to work as chief quality officer at a hospital or a large group. And, she asked me how to best pursue such a career.

I thought you’d like to hear the advice I gave her, so I’m presenting that today. But first, let me give you a little more information about this relatively new senior hospital executive position.

A New Position: Chief Quality Officer

As hospitals have begun to shift from volume- to value-based care, someone must be responsible for collecting and submitting data needed to demonstrate the organization's quality. And there are multiple processes, tools, and departments that must coordinate their efforts to make that happen.

Let me point out some of the duties of the CQO:

1. Implementing quality improvement measurement tools that can provide risk-adjusted outcome measures;
2. Implementing a tool that will cull clinical data for the purpose of reporting to CMS;
3. Writing and implementing a quality improvement plan that addresses all QI activities, such as
   • physician peer review,
   • chart reviews for quality monitoring,
   • implementing mandatory quality initiatives, such as those for central line infections and DVT prophylaxis,
   • initiating QI projects using QI models such as PDCA (plan – do – check – act),
   • performing root cause analyses for serious errors or sentinel events;
4. Monitoring public reporting (Hospital Compare, HealthGrades, LeapFrog, Truven Top 100 and others);
5. Hiring, directing and evaluating the director of QI department and often the Patient Safety Department; and,
6. Developing and promoting a culture of safety and quality.

I described my vision of the ideal QI program in Building a Great Hospital Quality Improvement Program.

I’ve seen tremendous growth in this field. This is primarily because CMS is penalizing hospitals financially that don’t meet quality, safety, length of stay and readmissions benchmarks. So, it now makes sense to invest 200- to 300-thousand dollars to avoid paying millions of dollars in penalties. And a CQO will promote quality of care and the hospital’s rankings and reputation.

Suffice it to say that there is a growing demand for physicians who meet the qualifications needed to lead hospital quality efforts.

My Roadmap to Chief Quality Officer

As I thought about her situation, there were several ideas that came to mind, and I shared those with her. Thinking more about the question later, here is what occurs to me:
In general, there is a pretty standard approach to shifting from a strictly clinical career to one in hospital administration, including a role as CQO. It involves these basic steps:

1. Overcome mindset issues
2. Demonstrate commitment
3. Utilize mentors
4. Obtain unpaid real-world experience
5. Get formal education
6. Acquire certifications and degrees
7. Obtain formal or paid experience
8. Actively pursue a CQO position

It’s sometimes possible to skip a step or rearrange the order. Some clinicians are thrust into a formal, paid position out of necessity and have to address multiple steps concurrently. Some physicians may obtain an advanced degree, such as an MPH, while completing medical school, not realizing it will help them in the search for a CQO job later. But most of us need to follow the steps I’ve outlined.

And there are tactics along the way that help accelerate the process, like joining appropriate associations, obtaining coaching, and networking.

1. Mindset

I’ve previously discussed the issue of mindset and self-limiting beliefs with at least two of my guests – (Episodes 10 and 18). Nina had already overcome that barrier. She was really excited about quality improvement and knew it was something she’d be good at.

2. Demonstrate Commitment

In the hospital setting, in order to be involved in formal and informal QI projects or standing committees, those in charge must understand that you have both interest and expertise. In an absurd example, the president of the medical staff is not going to recommend someone in the finance department to work on quality initiatives due to lack of both of these attributes.

Physicians already have the necessary expertise to get started. We know medicine, epidemiology, statistics, and basic infection control and quality improvement principles. But unless someone in a leadership position knows we’re interested, they won’t seek out our help.

Our interest can be demonstrated in only 2 ways: what we say and what we do.

In my conversation with Nina, I started by asking her if she had talked to the director of the Quality Improvement Department at her hospital. She had not. I told her the director would be the person who'd have the most information about the quality improvement enterprise there.

If there was a chief quality officer, she'd know who that person was, and she'd also know which physicians had been most active in the quality initiatives. If there's no chief quality officer, there might be a medical director or two that were involved in certain projects.

Photo by Dan Gold on Unsplash

And during that conversation, of course, Nina would tell the director that she was interested in working on QI projects, even if they did not involve her specialty. She’d also express this interest to the chair of her department and to the chair of the QI Committee and the president of the medical staff.

She’d also have a conversation within her medical group, to the extent there was a formal QI department or team.

Finally, she’d really demonstrate her interest by consistently attending the meetings, and contributing her input and time to the projects she was working on.

3. Mentors

I told her that based on those conversations, it should be possible for her to identify a mentor or two to begin speaking with. The Director of Quality, generally a nurse with special training, could be one of her non-physician mentors.

The best mentor would be a physician already deeply involved in quality, such as the CQO or medical director for quality. Remember, the typical mentor is generally a step or two ahead of you. I described how to identify and engage a mentor in Episode 4 of this podcast.

If there's no mentor readily available in your organization, it’s possible to identify mentors outside the organization. There are associations that physicians like Nina can join. They provide access to education and certification, but a big benefit is the networking and access to mentors.

The National Association for Healthcare Quality is probably the best known. There is also the American College of Medical Quality.

Another way to find a mentor is by using LinkedIn. Membership is free, so there's really no barrier to joining. On LinkedIn search for PEOPLE with the designation of chief quality officer or medical director for quality. You can filter the list by geographic LOCATION. If there are any reasonably close by, you can start by asking to connect on LinkedIn. Later you can speak with them directly, or even meet them face to face.

Then begin a dialogue, ultimately creating a relationship in which you can ask for advice as you pursue a career in quality improvement.

4. Informal or Unpaid Experience

I suggested to Nina that while speaking with the Director for Quality Improvement, she should inquire about ongoing quality projects that she can help with, and committee meetings she can attend.

The committee structure at a hospital is fairly formal. And each committee has assigned members. Nina was concerned that she couldn’t attend a meeting if she was not the appointed committee representative.

However, I advised her that most medical staff committees can be attended by any medical staff member. Just to avoid potential confusion, it is wise to speak with the chair of the quality committee and the department chair about attending as a nonvoting member because of your interest in quality improvement. You’ll quickly become a regular member.

Doing so demonstrates commitment, offers another opportunity for networking and mentoring, and begins the process of acquiring experience in QI. By observing the chair, you will also learn about planning and running meetings, project planning and working on an interdisciplinary team, all useful leadership skills.

Nina can also volunteer to sit on any formal quality or process improvement teams that her medical group might have. Learning about process improvement is very useful. PI projects are more common in the outpatient office and procedural settings than formal QI projects.

Lean is the term used for process improvement methods originally developed and implemented by Toyota. Lean process improvement uses techniques to reduce waste and improve quality in manufacturing. It’s now been applied to the healthcare setting.

Nina and I talked about learning Lean methods in the office setting, and possibly becoming certified in Lean process improvement. Knowing Lean concepts and procedures is very useful for those interested in quality improvement.

5. Formal Education

This brings us to the next step involving formal education. You can become a green belt or black belt in Six Sigma, another PI methodology designed to reduce variation in care. As noted a minute ago, there are courses in Lean process improvement.

The associations mentioned earlier (NAHQ and ACMQ) provide formal education in quality improvement, as do other organizations:

• Institute for Healthcare Improvement
• American Association for Physician Leadership (see Episode 24)
• Many specialty societies

6. Certification and Advanced Degrees

The NAHQ provides a path to certification in quality improvement through the Healthcare Quality Certification Commission. After obtaining the necessary experience and education, you can take an exam leading to achieve the designation as a Certified Professional in Healthcare Quality. It's a national certificate in quality improvement that demonstrates expertise in the field.

You can take that a step further and complete a master's degree in quality improvement. There are multiple university programs. The AAPL has helped develop a program specifically for physician leaders. It’s called the Master’s in Healthcare Quality and Safety Management (MS-HQSM) offered by Thomas Jefferson University.

I did not discuss this option with Nina during our call. It might be best to wait on pursuing this degree until after working in a formal QI position. That might allow you to get your employer to contribute financially and with time off to pursue the degree.

7. Formal Paid Experience

At some point, you’ll want to get into a formal QI role. If you have enough meaningful experience in quality and safety projects and with the CPHQ certification, you may be able to transition to a full, or near full-time position as CQO or VP for Medical Affairs.

More likely, you’ll split your time between clinical work and quality activities as the Medical Director for Quality in a health plan, medical group or hospital. In the hospital setting, you’ll bridge the gap between clinical and management realms. You’ll be promoting quality initiatives, reviewing quality data, presenting quality reports to medical staff departments, and working with individual physicians to improve their metrics.

During this phase of your career transition, you’ll continue to hone your quality and management skills. You’ll need to focus on leadership skills also, since the Chief Quality Officer serves as a senior level executive.

Therefor, you will need to shift your educational efforts to focus on leadership topics. Organizations such as the AAPL, the American College of Healthcare Executives and the Advisory Board are just a few that offer leadership education that will help you.

Reminder: Think About Your Resume

As Nina pursues her career as a CQO, she should keep in mind that she will be competing with other highly qualified physicians. At some point she’ll be sending resumes to prospective employers.

Those employers will be looking primarily at what this new CQO can do for them. So, they’ll be looking on the resume, and soliciting during the interviews, evidence of what Nina has accomplished.

They won’t put much weight on what committees she’s been part of, or which projects she’s worked on. Instead they’ll be looking for the initiatives she’s led. They’ll be looking for evidence of metrics she’s improved. Did she get length of stay down significantly, or reduce mortality or complications? Has she increased compliance with core measures? Did she help reduce the occurrence of never events?

Keep this in mind as you participate in formal and informal positions. Don’t be a passive participant. Be a leader in these positions. Don’t just remain a committee member. Step up to committee chair when you can. And keep track of the measurable improvements that result when you and your team tackle each quality initiative.

Time to Pursue a Career in Quality Improvement

By following the steps I’ve outlined, you’ll find a CQO position.

It'll be easier if you’re willing to relocate, but if you live in a large metropolitan area, you might not need to.

The job is very rewarding, because you’ll be helping to improve the care of thousands of patients through your efforts. Quality Improvement was always one of my favorite departments when I was CMO.

Quick Review

Let me quickly review the steps I’ve outlined for Nina to follow as she pursues a career in quality improvement.

She should:

1. Overcome mindset issues
2. Demonstrate commitment
3. Find and utilize mentors
4. Obtain unpaid/informal experience
5. Get formal education
6. Acquire certifications and degrees
7. Obtain formal paid experience
8. Actively pursue a CQO position

Along the way she’ll find appropriate associations to join, like the NAHQ and AAPL, she’ll network with colleagues, and she’ll take advantage of educational opportunities as they arise.

I hope you found this information helpful. If you have any questions, post them in the comments section below, or contact me at johnjurica@nonclinical.buzzmybrand.net.

Don't Forget to Download Your Free Guide to 5 Nonclinical Careers

As noted earlier, I’ve completed a Free Guide called 5 Nonclinical Careers You Can Pursue Today that outlines the steps for 5 more highly popular careers. It can be found at vitalpe.net/freeguide

Let’s end with this quote from John Ruskin:

See you next time on Physician NonClinical Careers.

The resources included in the podcast are all linked above.

Right click here and “Save As” to download this podcast episode to your computer.

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

The post Follow These 8 Steps to a Career in Quality Improvement – 027 appeared first on NonClinical Physicians.

I thought it would be helpful to discuss the organization. It is clearly dedicated to promoting physician leadership.  For more than 40 years, the AAPL has helped physician leaders develop their skills and enhance their careers. It has accomplished this through education, coaching, mentorship and by providing a supportive community of peers.

Introducing Dian Ginsberg

Dian Ginsberg currently serves as the Director of Career Services for the AAPL. In this capacity, Dian coaches physicians in the strategic development of their career plans.

She is a is a Certified Professional Career Coach (CPCC). And, she holds a master’s degree in Career and Technical Education from the University of South Florida.

Prior to working with the AAPL, Dian worked with the Association to Advance Collegiate Schools of Business. While there, she coached deans from MBA programs through their accreditation process.

She is passionate about career development. She believes that psychometric assessments can be leveraged to identify blind spots and help individuals become effective business leaders.

Dian provides a great overview of the AAPL's current educational, coaching and career services. She describes its newly enhanced psychometric assessment. This services helps physicians understand the types of career they're most suited for, and areas needing additional educational programming.

Certified Physician Executive Program

She also describes the Certified Physician Executive program. This certification requires about 125 hours of leadership training, with a final 3-1/2 day Capstone session with a cohort of peers. I found the program quite useful, both in terms of the content I needed to learn, and the live interaction with a group of my peers. And, I continue to remain close with some of those CPE colleagues.

Also, as I look through job postings, I increasingly see the CPE mentioned as a desirable certification for positions for physician leaders.

As mentioned in previous podcast episodes, I am promoting a fantastic online course produced by the White Coat Investor, Dr. James Dahle, called Fire Your Financial Advisor. It is the best and most convenient way for high-income professionals to learn about: handling student loan debt; creating budgets and financial plans; selecting the right disability, life and housing insurance; investing for retirement; asset protection; creating an investment portfolio; estate planning and much more. To learn more and to purchase with a money-back guarantee, go to vitalpe.net/money. All physician leaders should look at the course materials. As an affiliate promoter, I do receive a small stipend that does NOT affect your cost, if you purchase through my link.

In Closing

You can contact Dian Ginsberg's office at the AAPL by calling 800-562-8088.

You can also go to the web site at physicianleaders.org.

Let’s end today’s episode with this quote:

Next Time

In my next episode, I present a conversation with Kate Atchley, Ph.D., the executive director of the Physician Executive MBA program at Haslam College of Business. Having successfully graduated over 650 physician executives, she tells us much about who would benefit from such a program, and what to expect if you pursue a business degree.

Finally, be sure to subscribe to my newsletter so you don't miss it, using the form below.

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The post The Ultimate Resource to Spark Your Transformation to Physician Leader with Dian Ginsberg – 024 appeared first on NonClinical Physicians.

It’s just me today. A new interview will return next week. So, I’m going to take this opportunity to talk about something that's near and dear to my heart. As stated in the opening of my podcast each week, the goal of this podcast is to inspire, inform, and support you as you pivot to a nonclinical career.

Since I have not personally experienced most of the nonclinical careers out there, I bring guests on so we can learn together how to pursue them. But I do have personal experience in one of the possible career options, that of hospital management and administration.

FEATURED DOWNLOAD: Get “8 Steps to Becoming a Hospital Chief Medical Officer” so you can pursue this awesome career!

My Story

Let me tell you my story. After residency, I joined 2 physicians in a family medicine practice. I did pretty much everything I could to build the practice. I did obstetrics, took care of newborns, cared for office patients, did hospital rounds, and took care of nursing home patients.

Side Jobs for Cash

To fill my hours and generate additional income, I started working at the family planning clinic. After a year or so, I took a part-time medical director position. So, in addition to seeing patients in the clinic, I would sign off on medication purchases, review and approve policies and procedures, and collaborate with nurse practitioners to meet state requirements.

I later began working part-time in the hospital-based occupational medicine clinic. I learned how to take care of workers' compensation injuries, assess occupational exposures to lead and other toxins, and screen workers for high-risk jobs.

Eventually, I became the medical director for the “occ-med” clinic. That’s when I decided to continue my education, completing the requirements for a master’s degree in public health, with a concentration in occupational medicine.

And so, it went. I had this need to fill my time, and a desire to try new things.

Finding a Mentor

As a surveyor for my state medical society, I visited hospitals so they could be accredited to grant CME credit. In the process, I came to know another surveyor, who was also the chair of the state CME committee. His name was Don. I’ve spoken about him in a previous podcast episode titled Why Both a Coach and Mentor Are Vital to Your Career. He became one of my mentors.

After learning more about Don’s work as the chief medical officer for a large stand-alone hospital, the light finally went on for me. I’d pursue a career in hospital management.

Be Intentional

My point is telling this story is that I don’t want you to meander from side gig to side gig, hoping to find the right career by chance, as I did. No, I want you to be much more intentional than I was. My hope is that you actively search for a career that’ll excite and challenge you.

That’s why this week, I’m going to tell you why you should strongly consider a career in hospital management. I’m talking about work in senior management, such as chief quality officer, chief medical officer, chief medical information officer, or eventually chief operating officer or chief executive officer.

Other Considerations

But before I get into the 10 reasons why you should pursue a hospital management position, let me address a couple of glaring issues that might affect your ability to do so.

• First, this option may be quite unlikely if you don’t work for a hospital system or are on the medical staff of a hospital. If you’ve spent years working in an outpatient-only position after residency, an opportunity to test the hospital management waters might not arise. This career might be ideal, however, for hospitalists, anesthesiologists, emergency medicine physicians, or medical and surgical proceduralists who spend lots of time in the hospital setting.
• Next, some will say that a bigger factor when choosing a career might be your personality type. I think that assessing your personality can be very helpful. And some types might be best suited for specific jobs, such as utilization reviewer, expert legal witness or a job in pharmaceutical sales. But, hospital executive teams work best when there is a variety of personality types on the team.
• Finally, how much do you desire challenges, personal growth and continuous learning? I don’t think you should work as a hospital executive unless you are committed to continuous personal growth. In most dynamic hospital settings, you must be constantly trying new management models, adopting new technologies and continuously growing. It’s a bit different from trying to remain current in your specialty. If you’re happy seeing patients every day and just maintaining your skills, then you may not want to be a hospital executive.

If none of those three issues are stopping you, then let's get to the topic at hand.

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Why You Should Pursue Hospital Management

I’ll list all ten reasons first, then discuss each one individually. They are:

1. Leverage and Impact
2. Quality of Life
3. Personal Growth
4. Job Security
5. No Special Training to Start
6. Multiple Entry Level Options
7. Transferable Skills
8. Opportunity to Help the Profession
9. Opportunity to Improve Healthcare
10. Financial Rewards

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1. Leverage and Impact

I enjoyed providing medical care to patients. To a point. But it often seemed incremental. With many patients, the care seemed trivial. Treating the common cold and minor self-limited injuries, and reassuring the worried well just didn’t meet my definition of making a difference.

I became more energized by measurably helping groups of patients. As a physician executive, I was improving mortality and complication rates, and inpatient length of stay. You can too.

You can identify process breakdowns and eliminate them. With a multidisciplinary team, you might develop new service lines and new programs.

You obviously won't do this alone. In fact, that kind of impact happens because of leverage. The leverage involves leading teams, engaging staff and physicians, developing protocols, and implementing best practices together. I found that to be exciting and rewarding.

2. Quality of Life

Physician executives are busy, sure. But, we generally have better control of our schedule than most practicing physicians, especially employed physicians. Vacations can be taken without the need to find coverage for patients.

Staffing is handled by the HR department. The stress of malpractice is gone. Continuous learning is necessary, just as in clinical medicine, but it is easier to find time to attend educational conferences. And your direct reports manage the day-to-day. Taking call every 3^rd to 4^th day is a thing of the past.

3. Personal Growth

It’s true that as a physician, you’re trained to be a lifelong learner. And most of the physicians I know want to continue to grow intellectually, emotionally, and vocationally.

Once in an administrative position, there is a tremendous opportunity for personal growth.  Just as you learned medicine through an intense period of study that spanned up to a decade after college, you will need to devote several years of learning new business, management, and leadership skills.

New challenges will occur daily and you will be asked to take on ever-increasing responsibilities. You’ll continue to learn by being mentored and coached, by attending conferences, and by interacting with the rest of the senior management team on a regular basis.

After serving as CMO or CMIO, you may be asked to step into a COO or CEO role. Or you may make a lateral move to a much larger hospital or health system.

Such opportunities for growth don’t often arise in other non-clinical jobs.

4. Job Security

When I began, my research indicated to me that there was a new trend in hiring physician executives. I was the first VPMA and CMO at my hospital. The number of hospital physician CEOs continues to grow.

It seemed a fairly safe choice to make when I started, and it continues to be an area of growth and continuing demand.

5. No Special Training Required to Start

You already have many leadership skills. With a little mentoring, reading, and self-reflection, you can easily take the first steps to a management career.

Yes, you'll need to learn to collaborate and listen more; to let your direct reports occasionally fail so they can learn. You’ll need to continue your learning and growth as you mature in this new role, but you already have most of the skills and attributes needed to get started.

In fact, you have many more skills than the typical MBA or MHA trying to join the C-suite, because you already have an intimate knowledge of medicine and healthcare.

6. Multiple Entry Level Options

Most of us can’t just jump from full-time practice into a corporate position, whether in the pharmaceutical, insurance, governmental, or hospital setting. We must start at a more entry-level job.

Thankfully, in hospital management, there are many jobs that don’t require a special certification or an advanced degree that can lead to the C-suite. These include jobs such as medical director of a service line or unit, medical advisor for case management or utilization review, or medical director for quality improvement, patient safety, informatics, or continuing medical education.

Each of these jobs can serve as a stepping stone to a career as a chief medical officer, chief quality officer, or chief medical information officer.

7. Transferable Skills

With the business acumen and leadership skills developed as a hospital executive, pivoting to a position in a large medical group or an insurance company is quite doable. This is not an option for the chart reviewer, expert witness, or medical writer.

As a hospital executive, you’ll learn to better negotiate, communicate, run projects, plan strategically, set management goals, and read financial reports. And those skills can be applied in a medical group, in other corporate settings, and even as an entrepreneur.

8. Opportunity to Help the Profession

Physician disillusionment, frustration, and burnout can be improved by working in an organization that is led by physicians. The engagement of physicians is better, in general, when there is meaningful involvement by physician leadership in these organizations. As a physician leader, you will have the chance to address these issues directly.

When I was CMO, I was able to fight on behalf of one of my physicians to increase his salary when he was clearly being underpaid, for example.

9. Opportunity to Improve Healthcare

Would you hire an orchestra conductor who had never played a musical instrument? Would you hire a baseball or football coach who had never played the game? Yet most of our hospitals and health systems are run by businessmen and women who have never cared for a patient.

As I shared in my blog post Become a Leader and Save the Medical Profession, there is good evidence, both anecdotal and empirical, that hospitals run by physicians have better physician engagement, more cohesive teams, and better patient outcomes, in general.

Many of the top-rated hospitals in the U.S. are run by physicians, even though less than 6% across the nation have physician CEOs.

10. Financial Rewards

As an experienced vice president or chief medical officer, it should not be difficult to achieve salary and benefit levels that easily exceed the average income of most physicians, except for the busiest medical subspecialist or surgeon.

Most CMOs receive salaries in excess of $300,000 per year, plus bonuses, deferred compensation, and generous benefits. A quick scan through Form 990 of many nonprofit hospitals listed on Guidestar.org will often demonstrate total compensation well in excess of that number.

FEATURED DOWNLOAD: Get “8 Steps to Becoming a Hospital Chief Medical Officer” so you can pursue this awesome career!

Final Thoughts

It’s difficult to capture in words what it’s like to sit in a board room with 10 to 12 seasoned senior executives, creating strategic plans that will positively affect the lives of thousands of employees, and tens of thousands of patients.

If you’re looking for a career that can improve your quality of life, provide financial stability, job security, and growth, and the ability to positively impact populations of patients, a career as a physician executive is worth considering.

I’m recommending you look for mentors and network with physician executives to see if it’s a fit for you.

Let’s close with this quote:

Thanks for listening to today’s episode of Physician Nonclinical Careers.

Please sign up for my email newsletter so you’ll be notified of each new episode.

Next week, I’ll bring you an interview with medical writer Dr. Mandy Armitage.

So, join me next time on Physician Nonclinical Careers.

Resources

Resources are linked above.

Right-click here and “Save As” to download this podcast episode to your computer.

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher 

If you'd like to listen to the premiere episode and show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001

The post 10 Reasons Why You Should Pursue a Hospital Management Career – 020 appeared first on NonClinical Physicians.

It was early August, and Julie and Pat had already received the most recent update on Julie’s balanced scorecard. The scorecard listed four key responsibilities as well as the three goals she and Janice had agreed upon at the beginning of the year. The scorecard contained data through the second quarter, ending June 30.

After some small talk, and briefly discussing a new manager on one of Julie’s units, they shifted their conversation to Julie’s scorecard. During the previous year the entire organization had implement this formal, objective evaluation process as a pilot. It had worked well, so it had been officially implemented in January.

Reviewing The Scorecard

Pat commented, “I’ve had a chance to look over your scorecard. It looks like almost everything is on track. The performance of your department in the financial, growth and patient satisfaction areas is at the above average level. The second quarter performance in quality was better than the first quarter. So, I want to commend you for that.”

“I notice that you had an uptick in turnover of your staff in the second quarter. It looks like that will push your overall score for Employee Engagement below the minimum threshold. We should probably talk about that one. Is there something I can do to help support you in this area?”

Julie responded. “Yes, I saw the spike in turnover. So, I worked with HR and reviewed the turnover for the past five years. This issue seems to be related specifically to CNA turnover. Nursing turnover actually looks very good. Looking back, there always seems to be a peak in turnover in the second quarter.”

“I worked with my managers to identify any employee concerns. But the increase this quarter is actually smaller than the average second quarter increase for the past five years. I'm confident that the third quarter numbers will be quite low and our performance for the year will be very good.”

Pat responded, “That's good to hear. I think it was great that you took the time to look into this before our meeting today. Your explanation makes sense. Now let's look at where you stand on your three goals for this year…”

How to Evaluate Direct Reports

As a physician executive, you will be blessed with the opportunity to work with some great directors and managers. They are called your “direct reports.” You will be held responsible for their performance as well as your own.

In your executive role, you will use your management skills to identify goals and ongoing performance measures to demonstrate the success of your division. The performance of your directors’ departments and their employees will be key to your division performance.

As a wise administrator, you will have neither the interest nor the time to micro-manage your direct reports. However, you will tools that allow you to monitor their performance and alignment with the rest of your division and with the organization as a whole.

You will have limited time each month in which to do this. Frequently, you will spend significant amounts of time meeting with other senior executives, including the CEO. You will be presenting updates on your division's performance, writing proposals, negotiating contracts and providing coaching and mentoring to other team members.

Competing Responsibilities

If you are a hospital chief medical officer, you will be preparing presentations about quality, patient safety, infection control, length of stay, and performance by contracted specialty groups, as outlined in the Eight Essentials Abilities.

Therefore, you need a system for motivating and supporting your direct reports. You’ll require a tool that lists their core responsibilities, and monitors their success in achieving them.

If your organization still uses an annual evaluation based on each director’s job description, the evaluation will be subjective and not very useful. It won't do much to align your direct reports’ daily and weekly efforts with your division goals.

An annual evaluation is basically useless with respect to day-to-day management. What you really need is a tool that will provide clarity for your direct reports and enable them to focus on important goals, and maintain accountability throughout the year.

The best way to do so is to use a balanced scorecard and key performance indicators (KPIs). By agreeing on a set of ongoing performance expectations and tracking them over time, you will be able to encourage and support your team. This tool will also enable them to make course corrections during the year.

Backbone of the Scorecard: KPIs

For each director you will need to identify the primary performance measures. These are often called the Key Performance Indicators (KPIs). I will provide an outline of a general scorecard below, and then a specific example of a scorecard for one hospital department.

Many large organizations, including hospitals and health systems, design their strategic plans and management goals around so-called Pillars. These pillars represent fundamental areas that must be addressed by any organization to be successful.

Generally, these pillars will include domains such as:

• Growth
• Financial Stability
• Customer Service
• Excellence or Quality
• Employee Satisfaction

The organizational pillars can be spun off into individual department pillars that parallel them. For hospital-based departments, they should align with the pillars above:

• Growth
• Financial Performance
• Patient Satisfaction
• Quality and Patient Safety
• Employee Engagement
• Physician Engagement

To implement this process, at the beginning of each year we create a balanced scorecard that identifies KPIs that align with each pillar and then determine levels of performance for each metric. Some departments may not create a KPI for every pillar. For example, if a department does not interact with physicians, then it will not have a KPI for Physician Engagement.

Some pillars might have more than one important KPI. A department that produces revenues and has expenses (e.g., outpatient laboratory) might need a KPI related to both increasing revenues and reducing expenses. A non-revenue producing/support department such as human resources, quality improvement or risk management may have one KPI related to reducing expenses.

Some of the measures remain the same from year to year, but the threshold goals for each may change over time. The goal for each metric may be dichotomous (pass/fail) or tiered to three or more levels.

Avoid Subjective Measures

My preference is that the measures be completely objective and easily measurable. I prefer not to use subjective evaluations.

For example, I would rather not use an evaluation with measures such as these:

Instead, I prefer evaluations based on achieving measurable agreed-upon thresholds that have been discussed and clearly articulated by the supervisor. This means that staff are assessed based on results, or what they accomplish, and not on how it is accomplished.

A criticism of such a process is that if the focus is on one or two parameters, short-term gains will be sought rather than long-term success. For example, financial performance could be improved by terminating highly compensated employees and replacing them with lower paid inexperienced staff.

Balance is Critical

But that is avoided by using a balanced scorecard in which all of the important measures are addressed simultaneously, thereby avoiding the short-sighted focus on only one or two measures.

A decent balanced scorecard for the evaluation of a director over an imaginary hospital department based on the pillars above might include KPIs that look like this:

[Note that more detail would need to be provided – this is for illustration only. – VPE]

For the director of such an imaginary department, these measures would be measured, reported and discussed monthly by the VP or CMO and the director. The director would be encouraged to perform at the above average or superior range.

The VP would provide support and encouragement to achieve better results in any area in which acceptable or less than acceptable performance was being achieved. The support of the VP might be to intervene with other departments, or deploy resources (staff or budget dollars) from another department to help meet important goals.

Incentives

There are two primary incentives working to improve performance. The first is simply the recognition that comes from achieving the proposed goals. This recognition can be enhanced when the results for all of the directors and executives are shared across the organization.

This scorecard will be even more powerful if annual salary bonuses are tied to the outcomes. In such a scenario, the KPIs are reviewed and discussed with the director monthly or quarterly. Estimated bonuses, based on the most recent scores, are discussed at least quarterly. Then later, the bonus amounts (or lack thereof) will not come as a shock to the director.

The CEO and CFO will generally determine the amount of financial incentive that is potentially available, because it needs to be budgeted. The board may also need to approve the plan.

The total available for bonuses  may be a set dollar figure, or it may be set as a percentage of salary (e.g, 20% maximum potential bonus). The bonus payments may be canceled if the organization experiences a major financial decline in any given year.

Once a potential bonus is determined, you must create a formula for a partial payout because it is likely that KPI thresholds will only be partially met. The formula is based on the number performance measures and the importance of each.

Pharmacy Director

Let’s create a balanced scorecard for the (inpatient) Pharmacy Director, using the rules we set above.

Based on the CEO’s recommendation and board approval, all directors will be eligible for a bonus of 20% of gross salary if all KPIs are met at the Superior level (maximum threshold). The total potential bonus is being split equally among each director's five KPIs (possible $6,000 for each).

If the performance falls between Above Average and Superior, 80% of the bonus will be paid. When it falls between the Average and the Above Average, then 50% of the potential bonus is added. If a KPI ends the year below the lowest (Average) threshold, then the director is not eligible for a bonus on that item.

If the Pharmacy Director receives a salary of $150,000 per year, she is eligible for a maximum bonus of $30,000 at the end of the year, to be paid in March following the calendar year. The reason for the delay in payment is the processing time required to collect, tabulate, and review the data being used to calculate the measures.

Here is how the year-end analysis might look, assuming the performance listed in the 6th column:

Under this scenario, with a potential $30,000 bonus, the Pharmacy Director would receive $21,600 in March, based on relatively good performance compared to the annual goals.

In this example, just the basic outline is provided. In a real implementation, each goal and threshold would be clearly defined, and a determination made that the measure could be reported in a timely fashion.

Carefully Select KPIs

For the HCAHPS metric (patient satisfaction that is based on a mailed survey, collected and reported by a third-party), there is a significant time delay. So, the organization might need to use internally tracked measures that mirror the publicly reported measures.

It is best to use a monthly or quarterly scorecard that looks like this at each meeting with the Pharmacy Director:

Each month or quarter, you and the director will look over the current trends and develop plans together to improve performance for those areas not meeting the stretch goals.

The design of the KPIs and specific goals will need to be carefully considered. Looking over historical averages and trends can help to determine appropriate thresholds. It is also helpful to consider the variability of the measures. If there are wide swings in annual expenses in a given department, setting a goal may be more difficult than setting one for a department that performs within a tight range.

Wrap Up

The performance of your direct reports will sky-rocket if they transition from old style subjective evaluations to a balanced scorecard using Key Performance Indicators. Whether through peer pressure or financial incentives, measurement and reporting are the keys to improved performance.

An optimal scorecard will include KPIs that represent the major pillars defining the performance of the department. The KPIs must be designed with care, however. The metrics must be measurable and timely and meet the same guidelines as a SMART Goal. And they must be balanced, so that one area does not dominate the focus of the director and department.

Next Steps

If you are not using a balanced scorecard to provide ongoing objective evaluation of your direct reports, then commit to the following process over the next month or two:

1. Choose a director with whom to explore the use of a balanced scorecard;
2. Identify the major pillars of the organization and of the department;
3. Select 4 or 5 Key Performance Indicators based on their importance and measurability;
4. Begin a pilot beginning next quarter in which you measure, report and discuss the KPIs with your direct report;
5. If the process results in improved performance, then expand to other departments;
6. Share with your COO and CEO and the rest of the organization.

Then watch as the organization's performance really blossoms!

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The post How to Evaluate Direct Reports appeared first on NonClinical Physicians.

In actual fact, I had about 70% of a post ready to go two days ago. But I decided that it just sucked, so I sent it to the WordPress trash bin.

Since then, I have been vacillating over what to write about. At the same time, I have been thinking to myself “Why bother?” It is Thanksgiving day. Nobody is at home. And if they are home, they're cooking or eating dinner. Or they're already in a turkey- (tryptophan-) induced coma.

(Please, don't argue this point – I know that eating turkey does NOT cause increases in tryptophan, or melatonin. As a vegetarian that doesn't eat turkey, I can attest to the fact that I still get very sleepy after Thanksgiving dinner.)

Oh – one other admission…

If I was a good blogger, I would not be fretting over this, because I would have several posts already written and in the queue. That's more evidence of my failure as a blogger.

Maybe I'm being too hard on myself. After all, I ‘m not a professional blogger.

But I am trying to instill good habits in my blogging. And two of the rules are:

1. Be consistent and post on a regular basis, and
2. Write posts ahead of schedule so that little “hiccups” do not interfere with following rule #1.

Unforgettable Patients

So, I decided to write about the types of patients I have seen over the years that gently, or not so gently, reinforced my goal to stop doing any clinical work whatsoever. I had already begun working as vice president for medical affairs full-time. But I was still seeing patients 2 or 3 half days each week.

Keep this in mind: when you transition from clinician to administrator in your home hospital (as opposed to taking a job in a new city), it is easy to end up working one full-time and one part-time job. But I digress…

My primary reason for stopping the clinical work was to focus 100% on my administrative duties. I was getting very busy with administrative responsibility for six clinical areas within my hospital:

• Quality Improvement
• Risk Management/Patient Safety
• Pharmacy
• Physician Services
• Laboratory
• Imaging

Needless to say, the clinical work sometimes interfered with some of that work. Juggling both could get challenging. I clearly remember, however, some of the patient types that made me dread certain days in the office. I certainly did not miss the following types of patients when I left practice:

• The chronically ill and addicted. I had several Type 2 diabetic patients who were just NEVER able to get their glucose levels under control. I tried every kind of cajoling and combination of the  medications available. But they continued to drink alcohol, would not follow a diet, and refused to lift a finger to exercise. They were always surprised when they developed a foot ulcer or a scrotal abscess that would not heal.
• The 30- or 40-year old with one day of cold symptoms. They were often planning to travel and wanted to make sure they would not be ill while on their trip.
• The hypochondriacal patient with no confirmable medical illness. They came in weekly for whatever new hint of a symptom they had. According to my board prep CDs the treatment for this is to proactively schedule visits every week or so. What these patients really needed was reassurance and some face time with a physician. I get that, but it's hard to do when you're trying to care for several thousand patients with the help of a nurse practitioner and only 2 half days in the office.
• The overly familiar patient. He thinks that he's in the office to shoot the breeze for 20 minutes. My least favorite one of these had such severe obesity and sleep apnea that he had a tracheostomy and was on a home ventilator. His respiratory tree was chronically colonized with MRSA. He'd come in the office coughing through his trach and the staff would scatter.

Working in urgent care now, I don't usually see many of those kinds of patients. But I see many trivial illnesses that could be cared for via telemedicine or simple home remedies. It makes me wonder about the future of medicine.

It being Thanksgiving Day, however, I am reminded to be thankful. And I am. For my wife and family; my career; and even my patients. And my opportunity to try to serve my audience here on the Vital Physician Executive.

I hope you had a great week.

Thanks for listening.

John

The post Regrets and Nostalgia on Thanksgiving Day appeared first on NonClinical Physicians.

There is more need today than ever for skilled physician leaders. There are several specific steps that hopeful executives can take to enhance their competencies. But each physician will need to determine his or her own path based on his or her circumstances.

When trying to acquire these skills, it is best to follow Steven Covey’s admonition: “Start with the end in mind.”

Resources for the Emerging Physician Leader

Here are some resources that I found very helpful while I pursued my dream to become a physician hospital executive.

Join Pertinent Associations

Join organizations that provide support, education and networking. While I was actively working as a hospital CMO, I was a member of the American College of Healthcare Executives (ACHE). It provided some very good resources, including an annual conference to attend.

Since my hospital belonged to the American Hospital Association, I had access to its resources.

The dominant physician-led organization is the American Association for Physician Leadership (AAPL). I joined the organization in 1994 and have been a member ever since. In addition to conferences, workshops, and on-line activities, it publishes a monthly journal and hosts a job board.

Consider an Advanced Degree

Obtaining an advanced degree such as an MHA, MMM or MBA is not required. But it can be quite helpful for developing new management and leadership skills. In 1993, I completed a master's degree in public health, with a focus on occupational medicine. At the time, I was working as part-time medical director for an occupational health clinic.

Had I joined the AAPL before starting the MPH, and fully considered my long-term goals, I may have chosen to pursue an executive MBA or MHA. The MPH has been useful, nonetheless, in my work in quality, safety and population health initiatives.

Although it is not an advanced degree, the Certified Physician Executive (CPE) designation is evidence of competence in many physician leadership skills. It can be obtained by those with or without an advanced business degree through the Certifying Commission in Medical Management.

Get Training in Business and Management

Formal training relevant to the physician leader can be obtained through workshops, conferences and on-line programs. The organizations mentioned above all provide extensive education in business and management topics. If you are on staff at a hospital, you should be able to access some of the AHA programs. If employed, even part-time, by a hospital or other healthcare organization, you can probably access the ACHE conferences and workshops.

I attended many conferences organized by the AHA and ACHE over the years.

I also recall attending training provided by the Advisory Board, the Studor Group, Press Ganey, and the Greeley Company. Also, specialty societies, state medical associations and the American Medical Association offer additional learning opportunities for the emerging physician leader.

The additional benefit of attending AAPL courses and workshops, including on-line courses, is that many of them count toward CPE certification.

Read Books, Journals and Blogs

There are many good books to read on the subject. Some are written by physicians such as Atule Gewande, some are about physicians leadership (by Mark Hertling). Most of them address general business and leadership topics (by experts like Jim Collins, Peter Lencioni, Susan Scott and Sean Covey).

The AAPL publishes the Physician Leadership Journal monthly. Modern Healthcare is useful, as is Medical Economics.

There are several blogs devoted to leadership. This is a resource that was not available to me when I began my career journey into the executive realm.

I like blogs because they are contemporaneous, and often more focused and brief than a journal article. Also, they often allow for interaction with the blog author or other readers through the Comments section.

There are some great blogs devoted to leadership that provide free content and engagement with others interested in leadership, like MichaelHyatt.com, JohnMaxwell.com and SkipPrichard.com. I have been unable to find any blogs written for the physician leader that don't require membership in a parent organization like the AHA or ACHE.

Volunteer Your Services

A good way to get experience is to lead hospital based teams, and participate in professional society committees and nonprofit boards. At my hospital, I volunteered to work on the CME Committee. That led to being asked to join the Illinois State Medical Society's Committee on CME Accreditation. I later served as chair for that committee for five years. In that role, I attended the ISMS Board meetings.

Work on the Committee on CME Accreditation led to working as a CME surveyor and appointment to one of the Accreditation Council for CME's subcommittees.

In later years, I joined the local hospice board of directors, where I now serve as Vice President and President Elect. I have also served as a member and chair of our local health department board.

All of these experiences have given me an opportunity to set agendas, lead meetings, participate in strategic planning and review financial statements.

All of these experiences have helped me to hone my business and management skills over the years.

Take the Plunge

Once you have some education and experience, you will be ready to seek that full- or part-time job as a physician executive and leader. You will never be fully prepared. It is like marriage, the only preparation for being a physician leader, is to become a physician leader.

Now, take a deep breath and jump in. Our profession and our patients need you.

Have you found any blogs devoted to physician leadership? If so, please mention them in the Comments Section.

Don't forget to Subscribe to Future Posts.

And feel free to contact me directly at john.jurica.md@gmail.com

The post Resources for the Emerging Physician Leader appeared first on NonClinical Physicians.

But I was drawn to leadership opportunities. At our program, the chief resident was elected by the other residents. I “ran” for the position against one of my good friends in a low-key, respectful race.

I was very pleased when the residency director announced that I had been elected to the position!

I enjoyed attending the meetings with residency leadership, contributing the residents’ perspective to important conversations. I took on additional work planning events. I updated manuals and created a more comprehensive list of elective rotations available to the residents.

I had no inkling that these pursuits would be repeated later in my career. At the end of my residency, my only concern was to find a good position with a small independent family medicine group. I wanted to continue to hone my medical skills and practice family medicine, including obstetrics. I did not give any thought to being involved with management or leadership.

Eight years later, I started a process that would lead me to a full-time non-clinical position as a hospital executive. Physicians are being drawn to non-clinical careers for a variety of reasons. Some are disenchanted by long hours, declining insurance payments, greater paperwork burden, and burnout. Others find that clinical medicine is not as exciting or fulfilling as expected and are interested in work that is more entrepreneurial, innovative, flexible or challenging.

This has resulted in an explosion of physicians seeking part-time or full-time non-clinical careers. And it is not always easy to decide which potential job will be the most rewarding.

I’d like to describe why I chose a career as a hospital executive, and the pros and cons you may want to consider as you explore new career options.

Five Factors for the Potential Hospital Executive to Consider

I briefly contemplated moving into several non-clinical areas. One of my colleagues was doing chart reviews for an insurance company. Another had begun doing surveys for the Joint Commission. Consulting seemed to be exciting, but I worried about all of the travel that might be required. And I had read about other jobs like medical writing or working as an expert witness.

All of these options are legitimate, respectable jobs.  I listed other options in a previous post (Options for a Non-Clinical Career).

But there are several factors that drew me to a career as a hospital physician executive.

Leverage and Impact

I enjoy providing medical care to patients, addressing their fears and concerns, watching them respond to treatment and sensing their gratitude. But it often seemed so incremental. And with some patients, care was almost trivial – treating the common cold, minor injuries, insignificant infections, and the worried well.

I became very interested in helping groups of patients with illnesses where reductions in mortality or complications could be achieved. Working as a hospital executive provides that kind of impact because of leverage.

The leverage involves leading teams, engaging staff and physicians, developing protocols and implementing best practices. Effectively leading and managing can produce big improvements in outcomes.

Quality of Life

Physician executives are busy. But, we generally have better control of our schedule. Vacations can be taken without the need to find coverage for patients.

Staffing is handled by the HR department. The stress of malpractice is gone. Continuous learning is necessary, just as in clinical medicine, but it is easier to find time to attend educational conferences.

Financial

This career as a hospital executive has a good chance to maintain or improve income, especially for primary care physicians. As an experienced and valued vice president or chief medical officer, it should not be difficult to achieve salary and benefit levels that easily exceed the income of the average family physician, pediatrician or psychiatrist. The same may not be true for a busy cardiologist or surgeon.

Growth

Once in an administrative position, there is still opportunity to grow.  New challenges occur daily and opportunities often arise, moving into the chief operating officer (COO) position, for example. Also, many of us make a lateral move to the same position, but in a larger hospital or health system.

And there are more opportunities for the physician executive to fill the CEO role as well. Such opportunities for growth don't often arise in many of the other non-clinical jobs.

Some of us shift into a different type of healthcare organization, like a large medical group or an insurance company. This is not something the chart reviewer or writer has as an option.

Stability

My research indicated to me that there was a new trend in hiring physician executives when I initially began my transition. I was the first VPMA and CMO at my hospital.The number of hospital CEOs continues to grow.

It seemed a fairly safe choice to make when I started, and it continues to be an area of growth and continuing demand.

Final Decision

A decision to move into one of these areas is not set in stone. Try different activities. See what you really enjoy doing. But if you're like me, and are looking for a career that offers an ability to impact patients, improve your quality of life, enjoy financial stability job security, and growth, a career as a physician executive is worth considering.

What are the other factors should be considered?

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