Physician Coaching Services

[FamDocNC]

Anyone ever hired one of the physician/executive coaches?

I have partnered in our small town primary care office with 8 clinicians and though I often fancied myself a good leader, I am struggling to get this team moving and pulling in the right direction. Getting this group of talented doctors and experienced mid-level clinicians on the same page is imperative for our financial success and work life balance.

Should I just get some books and read or have people had success with the paid services?

[Kamban]

Maybe the physicians should meet together once a month and have open honest discussion on where the group should be heading, before you go ahead and hire one of the services.

[FamDocNC]

We meet pretty regularly (most months) its just not productive and I cant get us unstuck when we do meet.  Wondering of they have helped anyone develop the skills to navigate these traps.

[lilsnappa]

You may find some value in the writings/teachings of Patrick Lencioni.

All of his books are quick reads and written as fable, so its not a dry text book. I've recommended a few of his books to different Executives I've consulted for and have shared many of his teachings with clients in the business world.

 

 

 

[jhwkr542]

There seem to be a lot of generalities in this discussion, so it's hard to provide much advice. I think both reading books and hiring advice may have the same problems. When you say "pulling in the right direction", what does that mean? You'll need to propose specific goals and get everyone to agree on them, the more specific the better. It's very similar to an IPS. Mine doesn't say "get rich," it says pay off student loans and states the monthly payment needed every month and then how much I'll add from my quarterly bonuses.

[q-school]

Why can't you make progress?
What issues make you get stuck? Process or specific agenda items?

[FamDocNC]

I was trying to avoid the details looking more for peoples experience with the consult/"physician coach" process if anyone has had success with them in the past

But what the heck - We are in a growing area and have a ton of patients that could/need to be seen.  The more senior partners have concerns about getting bigger saying in primary care we don't necessarily get any benefit from getting bigger.  They also have a smaller window to see the benefits of this and I am 4 years out of residency and have a much longer horizon.  But the same old pressures of an independent family practice are fracturing the team unity to get productive and move forward on the transition from fee for service to macra/mips/pcmh/etc/etc/blah and to answer expansion plans. Ill take any thoughts

[q-school]

In my experience these are fundamental differences that are generally hashed out before the group meeting. Sure details can be ironed out but you need to have a clear understanding of how decisions are made.

Is it a vote? Supermajority? Is it decided by managing partner?

If people are dominating the meeting, do you use roberts rules of order/or alternative to help steer the decision making process?

If the senior members don't want to do something strongly, you are going to have to tread carefully.

I don't really think a coach will help you here. As I understand your problem, you are hoping to expand. You need be group to agree to hire more. Potentially this will affect short term incomes. I think you need to discuss what t would take to get senior members to agree. It is interesting because often senior members are concerned with legacy and have multiple roles in the community where they want the population to be well taken care of. Do they have a timeframe for retirement they are willing to share? Can they be bought out and put on salary? Will local hospitals support new hire salaries? Etc etc. many possible solutions.
sorry if I misinterpreted your post.

Good luck

[StarTrekDoc]

Ah, the pivot from Fee Service to Value based care.    That's a very hard one to do by itself let alone other confounding factors -- EHR challenges, staffing ratios , role types and how all that balances into the equation.

There's nothing out there that does this that I've seen since it's a lot of different issues ongoing that could be the pain points.

Motivational speaking to 'getting to go' is one thing.

Seeing the financials of short term/long term is a whole other issue and sounds like a primary sticking point -- that's where a specialist in the numbers for your specific situation would be of benefit and really depends on the will of the docs -- stay small and niche - boutique;  or grow and dive into MACRA/P4P - value based care PCMH model care.   It's not always a generational gap either.

 

[erictait]

I have been interviewing practice management firms for a project we are working on.

I have found one that I absolutely love and they do change management for health systems as well as independent practices particularly around transitioning to a non-fee for service world.

They will gladly give you a free consult to see if it is a fit.

Just private message me and I can connect you.

 

 

[FamDocNC]

Thanks for all the help folks, I have ordered a book and I am going to work on making at least portions of the decisions in less formal meetings before the group gets together formally and see where that takes me.

WCI nation rocks

[Zaphod]

In meetings you have to keep people from ranting and constant reiterating of a single idea. Make it very organized. Lay out a problem, field succinct solutions, have some kind of weighing in or vote, enact or discard solution and move on. These may have to be timed, but you cant just let people ramble and anecdote, etc...and sadly physicians are absolutely terrible at not doing that, and are pretty bad in meetings at being efficient.

Whatever the issue is doesnt matter, you need a good framework for how to discuss, evaluate, manage solutions and efficiently move through all these phases at a meeting.

[SValleyMD]

SPOT ON zaphod.. you just described our weekly meetings to a T.. drives me absolutely bonkers.

Old dudes rant about absolute nonesense, time gets waisted and nothing gets done or accomplished, all for it to be repeated for the next meeting.

[pulmdoc]

Zaphod is spot on.  This is why I detest scheduled weekly/monthly meetings, because the meeting is set before the agenda is.  Everybody comes to the meeting with their own agenda and it is hard for the leader to rein people in.  I would much rather schedule meetings organized around a common agenda like "I think we need to decide if we are going to participate in BIGHEALTH's ACO this year" with pro/con laid out, discussion, vote, adjourn.

[q-school]

The question is whether the vote means anything.