Making long-term strategic plans can seem daunting for hospitals and health systems, with reform unfolding and the presidential election looming with an unknown outcome. However, one aspect of strategic planning — medical staff planning — is more essential for hospitals than ever, especially considering the country's growing physician shortage. Robert Harrison, manager of DGA Partners, says hospitals should look at their overall medical staff plan every three to five years. However, every year, hospitals should assess their progress toward meeting development targets and adjust accordingly.
Here, Mr. Harrison reveals five things to keep in mind when developing a medical staff plan.
1. Don't forget the basics of medical staff plan development. There are four basic factors Mr. Harrison says are critical to remember:
2. Anticipate physician resistance. Mr. Harrison says hospital executives often underestimate the level of pushback from current physicians about bringing in new physicians as part of their medical staff development plan. Current physicians will most likely be concerned with how the new additions will affect their referrals and patient volumes. "More often, it is the specialists who will show the most concern," Mr. Harrison says.
While strategies to alleviate resistance depend on the nuances of the situation, Mr. Harrison says it is always important to keep the conversation open between hospital executives and physicians. One example he gives when physician groups are not accepting a certain insurance plan that the hospital would like to include. In that situation, hospitals can set priorities to work with existing physicians to take on different payors. If they refuse, the hospital can then align with different physicians or bring in new ones.
3. Gauge the community's physician needs. There two main ways to get an estimate for what a hospital's community needs in terms of physicians. One method is to directly survey physicians already in the community. They can answer questions about things such as waiting times for routine visits and how often they need to refer to specialists outside of the community, which can provide insight into the most demanded specialties in the community.
Another method to gauge a community's physician needs is quantitative analysis. There are methodologies available that can estimate a population's needs using ratios of the number of physicians for a certain size population. These demand estimates are compared to the supply of physicians in the community to determine surplus or deficit levels. If using these methodologies, hospitals should be sure the demographic information is current.
"Planning standards should be periodically updated to reflect changes in the industry and how doctors practice medicine," Mr. Harrison says. This will show if the community has a shortage of a certain specialty or physician type, which can then be addressed in the medical staff development plan.
4. Set realistic physician recruitment goals. Many hospitals set high recruitment goals and then struggle to meet them. Hospitals also underestimate the cost and difficulty of recruiting physicians. "Employing physicians has a steep financial requirement," Mr. Harrison says. This rings especially true during a physician shortage, such as that facing today's market. "When physician demand is higher than supply, hospitals need to find ways to attract physicians to them," Mr. Harrison says. "That might mean offering financial assistance or employing them," he adds.
5. Use the executive team wisely. Usually, medical staff planning involves the input of a steering committee made up of senior managers and physician leaders.
The CEO is not usually directly involved in the planning stages. "The CEO's primary role is selling the plan to the medical staff and the hospital board," Mr. Harrison says.
The CMO, on the other hand, should be extremely involved. "The CMO should have a finger on the pulse of what's going on with the medical staff," Mr. Harrison says. Therefore, he or she should take part in the entire development of the plan and should be explaining it to the medical staff directly.
The hospital's employed physicians do not typically have a significant role in developing the plan, but that does not mean they should be left out in the cold. Physician leaders in the hospital should be on the steering committee. The planning process should also include soliciting input from a mix of private, independent and employed physicians. either through interviews or surveys, to get input from different points of view.
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Here, Mr. Harrison reveals five things to keep in mind when developing a medical staff plan.
1. Don't forget the basics of medical staff plan development. There are four basic factors Mr. Harrison says are critical to remember:
- Align the medical staff plan with both the hospital's strategic and clinical programming goals. "Physicians are the vehicle hospitals use to get to those goals," Mr. Harrison says, so all three plans should be integrated.
- Strive for the correct balance of primary care physicians and specialists. Hospitals need a good number of committed, loyal referring primary care physicians and an adequate number and mix of specialists to give the PCPs variety for referral.
- Know the hospital's preferred physician alignment model. Should the strategy call for employed physicians, affiliations with private practices or a mixture of the two?
- Anticipate physician retirements and reduced physician productivity that comes as physicians near retirement, and use that information to inform the timing of recruitment efforts.
2. Anticipate physician resistance. Mr. Harrison says hospital executives often underestimate the level of pushback from current physicians about bringing in new physicians as part of their medical staff development plan. Current physicians will most likely be concerned with how the new additions will affect their referrals and patient volumes. "More often, it is the specialists who will show the most concern," Mr. Harrison says.
While strategies to alleviate resistance depend on the nuances of the situation, Mr. Harrison says it is always important to keep the conversation open between hospital executives and physicians. One example he gives when physician groups are not accepting a certain insurance plan that the hospital would like to include. In that situation, hospitals can set priorities to work with existing physicians to take on different payors. If they refuse, the hospital can then align with different physicians or bring in new ones.
3. Gauge the community's physician needs. There two main ways to get an estimate for what a hospital's community needs in terms of physicians. One method is to directly survey physicians already in the community. They can answer questions about things such as waiting times for routine visits and how often they need to refer to specialists outside of the community, which can provide insight into the most demanded specialties in the community.
Another method to gauge a community's physician needs is quantitative analysis. There are methodologies available that can estimate a population's needs using ratios of the number of physicians for a certain size population. These demand estimates are compared to the supply of physicians in the community to determine surplus or deficit levels. If using these methodologies, hospitals should be sure the demographic information is current.
"Planning standards should be periodically updated to reflect changes in the industry and how doctors practice medicine," Mr. Harrison says. This will show if the community has a shortage of a certain specialty or physician type, which can then be addressed in the medical staff development plan.
4. Set realistic physician recruitment goals. Many hospitals set high recruitment goals and then struggle to meet them. Hospitals also underestimate the cost and difficulty of recruiting physicians. "Employing physicians has a steep financial requirement," Mr. Harrison says. This rings especially true during a physician shortage, such as that facing today's market. "When physician demand is higher than supply, hospitals need to find ways to attract physicians to them," Mr. Harrison says. "That might mean offering financial assistance or employing them," he adds.
5. Use the executive team wisely. Usually, medical staff planning involves the input of a steering committee made up of senior managers and physician leaders.
The CEO is not usually directly involved in the planning stages. "The CEO's primary role is selling the plan to the medical staff and the hospital board," Mr. Harrison says.
The CMO, on the other hand, should be extremely involved. "The CMO should have a finger on the pulse of what's going on with the medical staff," Mr. Harrison says. Therefore, he or she should take part in the entire development of the plan and should be explaining it to the medical staff directly.
The hospital's employed physicians do not typically have a significant role in developing the plan, but that does not mean they should be left out in the cold. Physician leaders in the hospital should be on the steering committee. The planning process should also include soliciting input from a mix of private, independent and employed physicians. either through interviews or surveys, to get input from different points of view.
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