Home' The Source : Third Quarter 2013 Contents so they can be paid in cash. Still others have
stopped taking new Medicare/Medicaid
patients. As the economy improves, sur-
veys suggest that many older physicians,
who deferred retirement because of the
recession, will retire or substantially reduce
patient care duties.
Countering that somewhat gloomy
backdrop, fortunately there are also many
who are simply rolling up their sleeves.
Physicians do understand that healthcare
is changing, and we have many among our
a liates who are working closely with
administrators, nurses, pharmacists and
others to navigate these changes together.
It can be an exciting time to develop new
programs and make a big impact on the
quality of care for one's community.
What advice would you have for sup-
ply chain leaders to best support clinical
Get physicians and supply chain profes-
sionals together early and often. Physicians
understand the need to purchase in a cost-
e ective way. What they ask is to be at the
table with supply chain to sort through the
choices, to see and get comfortable with
any data being used, and to share clinical
issues that need to be considered.
Bringing physicians to the table early and
keeping the focus on better clinical care
will go a long way toward solving many
challenges. Physicians are wired to be help-
ful and need to believe in a project in order
to engage in it. We have lots of competing
priorities, so if we're going to engage on a
supply chain project, it has to engage us in
a way that we know will positively a ect
people's lives. If not, we have many more
things competing for our time.
It's important to look at the whole epi-
sode of patient care. For example, using
a cheaper drug may save the pharmacy
department money, but it may require
extra sta or procedure-room time. Certain
medications may be more expensive, but
they may eliminate the need for blood test-
ing. One radiological product may be less
expensive than another, but it may require
more sta time to mix and use. Looking at
Although both physicians and supply chain professionals have the same ultimate
goal---improving patient care---sometimes the pursuit of that goal can seem to take
divergent paths. Barbara R. Paul, MD, chief medical o cer at Community Health Systems
Professional Services Corporation, added her tips to those Kenneth Cohn, MD, shared
in the Fall 2011 edition of The Source. She outlines some of the challenges from the
perspective of a medical practitioner, as well as some solutions for helping physicians
and supply chain professionals work together more productively:
Understanding the physicians' perspective:
• Physicians are trained to be individualists. Most have little to no communications
or negotiations training. In a survey of MBAs and physicians, when asked, "What
percent of your grade in training was based on team projects?" MBAs answered 30
to 50 percent, while physicians answered zero.
• Employment doesn't equal alignment. Being employed by a hospital isn't su cient
to spur physician's engagement on administrative issues. It may move those issues
up the list, but it won't necessarily move them to the top.
• Physicians have multiple loyalties, appropriately so. That's why they must believe
in a project's ability to positively a ect patient care in order to fully participate.
Avoiding the pitfalls of poor engagement:
Physicians are trained to take large amounts of information and distill it to a single
diagnosis. It is in the DNA of docs to be problem-solvers, but they need to have the data.
Physician/supply chain meetings can go astray when:
• Physicians are brought into meetings as figureheads, not participants.
• Progress isn't charted, leading physicians to think that nothing is getting done and
their time is being wasted.
• Physicians are given grudging acquiescence ("let's call a truce"), instead of full part-
nership and leadership.
Framing the physician/supply chain meetings properly:
• Choose the right words from the beginning. Frame the project so that it's clear how
it will make a di erence in patient care. Give the clinical rationale.
• Bring good data. Physicians are generally objective when using good comparison
data and criteria.
• Say "no" when that is the answer. Sugar-coating the hard issues isn't necessary.
• Bring in a few physicians early to help frame the project, create a shared vision and
set the final goals. These lead physicians also can serve as personal mentors to others
who will be part of the project's implementation.
• Discuss goals and milestones upfront. Divide the project into chunks so that all can
watch the progress. Come up with a written action plan of interim outcomes that can
be physically checked o as they're done.
Making Medical Practitioners
a Full Partner in Healthcare
| Q&A WITH BARBARA PAUL, MD |
continued from page 32
continued on page 36
34 The Source | Third Quarter 2013
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