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The Prince, written by Niccolò Machiavelli (pictured), argued that it is better for a ruler to be feared than loved, if you cannot get both.both

BMJ article looks at effectiveness of development programs for physician leaders

The Prince, written by Niccolò Machiavelli (pictured), argued that it is better for a ruler to be feared than loved, if you cannot get both.

Do programs to develop physician leaders actually work? A BMJ Leader (as in British Medical Journal) article notes that “leader development has been the signature feature of leading companies and appears to be a burgeoning interest in healthcare organisations, it is important to assess the impact of such programmes, especially as resources are expended towards them in an era of constrained resources in healthcare. The impact and value of programmes must be addressed individually, and each activity must be contextualised for the culture and priorities of the institution. While some available studies demonstrate value and high organisational impact for such programmes, it appears that rigorous studies are relatively few and that most available studies document self-reported….

“Assessments of the various Cleveland Clinic programmes represent our attempt to assess the impact of physician leader programmes on organisational performance. Future goals for this research are to further examine both the learning, behavioural, and organisational impact of alumni of leader development programmes and to consider their cost-effectiveness (eg, by comparing the programme costs with the financial impact of initiatives led by programme alumni).”

To read the article, please hit this link.

Leveraging implementation science

An article in NEJM Catalyst looks at the major shifts to come over this decade in the design of health systems and health care in general, propelled by digital health, growing consumerism, mounting financial constraints, and accelerated by COVID-19.

The authors conclude:

“It will not be easy to get to this new world, and it will be realized faster in some places and domains than others. However, if payment systems reward organizations and practitioners for doing better, we believe they will find ways to innovate and successful innovations will spread rapidly. Some innovation will rely on digital technology and AI, but much of it will relate to leveraging the techniques of implementation science — the scientific study of implementing research findings in practice, moving care away from hospitals, and bringing together health and social care.”

Please this link to read the article.

Global lessons for U.S. primary care

An article in NEJM Catalyst uses a global survey of innovative health-delivery to imagine the future of primary care.

It looks at provider organizations in Mexico, sub-Saharan Africa, Nepal and Rwanda as examples of approaches/programs that can be used to improve primary and preventive care in the United States.

To read the article, please hit this link.

He’s upbeat about post-COVID health-care sector

Graphic by K. Aainsqatsi

An article in Physicians Practice by John Nantz looks at the future of the health-care business after COVID-19.

Among his observations:

“Now, the business of healthcare seems to be well on the road to recovery. Recent research conducted by my firm, Redwood Advisors, and Evolve Healthcare Marketing indicates that practice volumes have been steadily returning. Roughly 25% of practices have already seen patient volume return to a pre-COVID level, and another nearly 25% expect it to return by the end of Q1 2021. In contrast, less than 10% believe practice volume will return after Q2 of next year, and only 18% remain “uncertain” as to when volume will return.”

The article concludes: “In light of the November {and after} surge in cases, it is possible that businesses, including physician practices, may be heading to another slow-down. However, with PPE, staff bonuses, and telemedicine structures now in place, practices will be well-equipped to weather COVID-19 and stay-at-home orders.

To read the article, please hit this link.

Nurturing trust in pandemic

  • Ghazala Q. Sharieff, M.D., chief medical officer at Scripps Health, writes in NEJM Catalyst about senior management’s engendering of, and maintaining, trust among physicians, other staff and patients during the COVID-19 pandemic, and implementing several mechanisms for ensuring that communication is regular and transparent and addresses the needs of the community.

To read the article, please hit this link.

The future of the CMO

In a NEJM Catalyst conversation with Thomas H. Lee, M.D., Andrew Masica, M.D., chief medical officer of Texas Health Resources, discusses how the new generation of CMOs will need to be comfortable being innovative change agents as the market heads toward value-based care.

He describes three different kinds of CMO’s.

To read the dialogue, please hit this link.

Partly scary predictions for hospitals in 2021

Robert King of Fierce Healthcare has come up with five predictions for the hospital business in 2021. They are:

“Hospital consolidation likely to increase at a rapid pace.”

“Patient volumes will continue to be disrupted.”

“An unstable payer mix could roil finances.”

“Telehealth visits will continue to skyrocket.”

“Don’t expect a major new round of relief funding.”

To read the article, please hit this link.

How huge Providence Health chain got back to pre-pandemic volumes

NEJM Catalyst editor-in-chief Tom Lee, M.D., talked with Amy Compton-Phillips, M.D., executive vice president and chief clinical officer of Providence Health & Services, the huge Seattle-based chain, with 51 hospitals and more than 800 clinics in western states, about clinical leadership as the company navigated the health crises of the past year, including COVID-19, hurricanes and massive wildfires, and got back to pre-pandemic volumes.

Among her remarks:

“….{W}e have this large-scale change infrastructure of vision, trust, data, capacity, and alignment. In COVID, the vision was very clear: survive COVID… so everybody knew exactly where we were going — we were trying to get to the other side of a pandemic. Trust. We had all worked together and trusted that each was doing their own job and not try to manage it but allow it to happen. Data. We built an amazing data architecture that has allowed us to have not only insight into what the outcomes are that we’re seeing, but also predictive analytics, and now we can see with pretty good fidelity about 2 weeks into the future….  Capacity. We were very creative in creating capacity, and now that capacity generation is going to serve us well into the future. Alignment has been really essential for us to be able to flex people into the roles that we need [in order for us] to [provide] care in a new way. [In terms of] the platforming article, I’m really glad we had that model before COVID hit because it allowed us to go from 0 to 60 very rapidly when we needed it.

To read the whole interview, please hit this link.

Cross-hospital collaboration in response to pandemic in New York City

An article in NEJM Catalyst looks at lessons learned from hospital collaborations in response to the COVID-19 pandemic in New York City.

The authors conclude:

“As NYC became the epicenter for the COVID-19 pandemic, the hospitals of the Department of Medicine at NYU — BH, NYU-Tisch, NYU-Brooklyn, and the VA — developed multiple strategies for communication, surge capacity, clinical guidelines, and staff wellness. Despite these four hospitals being distinct, there were many uniform approaches that can be adapted by hospitals of any affiliation or size. Collaboration within academic affiliations and, more globally, across the country will be beneficial to leadership, staff, and patients. This overview can be used for diverse hospital systems that are currently facing, or are likely to experience, a surge of patients with Covid-19 or future disaster planning of any kind.”

To read the article, please hit this link:

Growing economic stress for many physicians

An article in Physician’s Practice looks at how “instability in compensation and the massive move of physicians from private practice to employed models could be indicators of trouble ahead for physician compensation.”

Actually, a lot of physicians, especially those in private practice, are already under growing financial stress. COVID-19, of course, has made everything worse.

To read the article, please hit this link.

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