A winning formula

By Frank Lloyd, Ph.D., Associate Dean, Executive Education, SMU Cox School of Business

When I met with a physician leader at the massive Baylor Health Care System complex in Dallas, it was not to diagnose one of my ailments. Instead, Dr. Carl Couch, chairman of the Baylor Health Care System's Best Care Committee, presented me with a serious organizational problem.

“These newly trained physician leaders would enable Baylor to meet the challenges of today’s healthcare business and ensure tomorrow’s leaders are in place today”
-Frank Lloyd

According to Dr. Couch, to achieve maximum clinical and operational results, today's healthcare organizations need physician leadership that is tightly integrated with non-physician managers. But this is difficult because many physicians are not temperamentally disposed to leadership roles in organizations. As Dr. Couch put it, "physicians' independent perspective often differs from organizational perspectives, yet harmonious reconciliation of those differences is critical for ideal healthcare delivery and improvement." Furthermore, years of arduous clinical training do not provide physicians with the interpersonal, influencing, and basic business skills needed to meet the demands placed on healthcare leaders today. As a result, many physicians often find themselves unprepared for the leadership roles-as hospital medical staff officers, department chiefs, group practice leaders, and clinical service line managers-now asked of them.

Challenge

The mismatch between physicians' temperament and training and the demands for healthcare leadership presented significant operational challenges for Baylor Health Care System:

• Ineffective communication by physicians led to unproductive dialogue with administrators and fellow healthcare team members.
• Physicians could not contribute fully in setting and achieving effective healthcare delivery strategy.
• Physicians lacked business acumen skills needed to understand the economic and financial aspects of hospital administration.
• Physicians were unable to provide motivation and direction in a continually changing healthcare environment.

It was clear that the organization needed to enable high potential physicians to become better business leaders, and they turned to a business school for the cure.

Discovery

The key to successful collaboration between a business school and a business organization is communication. Both must be willing and able to invest time to formulate content and delivery structure that ensure application of new learning. In this case, SMU Cox staff and instructors knowledgeable of the healthcare industry met with Baylor Health Care System leaders who could clearly articulate desired educational outcomes. That enabled a dialog to take place in which each listened to the other, questioned and challenged. The goal was to better equip physician leaders to be more effective and to work collaboratively in clinical process improvement. These newly trained physician leaders would enable Baylor to meet the challenges of today's healthcare business and ensure tomorrow's leaders are in place today.

Outcome

The result was an advanced leadership program for physicians. It included education in the disciplines of negotiation, conflict resolution, personal influence, change management, finance, human resources, and strategic planning. The program was taught using action learning methods that promote prompt application of new knowledge. The program design-modules spaced out over time-supported behavior change. This structure not only fit the physicians' schedules, but permitted practice, debriefing and feedback from multiple sources-fellow participants, sponsors, and formal instrumentation.

Extensive involvement on the part of Baylor Health Care's current high level leaders ensured on-target content, promoted a high (95%) attendance rate, and encouraged application of new skills. Presidents of all Baylor Health Care System entities nominated physicians to fill the sixty places in the initial offering. System executives led small informal meetings between modules where participants discussed application of previously presented material. They hosted these two hour colloquia at night in their homes, and the lively interaction in a casual atmosphere deepened relationships within the leadership group.

Impact

All Baylor Health Care System hospital presidents were polled at the end of the first year and unanimously reported that the outcomes were met. They had seen evidence that their physicians: 

• Were aware of personal leadership styles, strengths, and opportunities to develop new leadership skills.
• Could select effective strategies to resolve conflicts.
• Recognized areas of influence in organizational relationships and improved communication with direct reports, colleagues and administrators.
• Applied negotiation skills and investigational inquiry to deliver healthcare and meet objectives efficiently.
• Identified areas where strategic communication can solve healthcare delivery problems.
• Understood core financial issues and metrics relevant to hospital management, leading to more effective collaborative care delivery.
• Were able to contribute effective leadership to organizational change initiatives.

Furthermore, the presidents received very positive feedback from their local participating physicians. For example, one physician stated, "I believe the SMU physician leadership course has been a solid avenue to nurture promotion of doctor leadership in our healthcare system. This course has raised the bar for developing the skills necessary for physician entry into new roles. The creation of this type of education reflects the value now being placed by our senior administration on developing physicians for key roles in the future. Access to the SMU Business School faculty and resources has been a positive stroke in advancing this education. This adds even more credibility to Baylor's approach to physician development. The blend of didactics and interactivity afforded to us by the teachers has been a major success."

As a result of the program's positive outcomes plus its sponsor and participant endorsement, it will continue to be offered in the future. It also has been extended to nurse and administrative leaders.

Collaborating for Success

The changing dynamics of today's healthcare marketplace demand increasing reliance on physician leadership. And physicians are too often ill-equipped to meet these demands. Fortunately, forward thinking healthcare organizations like Baylor Health Care System can turn to leading business schools to collaborate and adapt cutting edge business knowledge and teaching tools to align system-wide leadership and prepare them to deliver high quality and efficient health care today-and tomorrow.

About the Author/Case Study

Frank R. Lloyd, Ph.D., is Associate Dean of Executive Education for the Cox School of Business at Southern Methodist University. He is responsible for programs targeted to executives, managers, and working professionals. Dr. Lloyd joined SMU's Cox School from the Thunderbird School of Global Management where he most recently served as Vice President of Executive Education. Prior to joining Thunderbird, Dr. Lloyd was a human resources management executive with General Motors.

Carl Couch, M.D. and M. M. M., is a family practitioner and Chairman of the Baylor Health Care System's Best Care Committee, as well as the Director of its Physician Champions program.

In 2008 SMU Cox Executive Education was presented the silver award for Excellence in Academic Partnerships, part of the "Learning in Practice" annual awards, from Chief Learning Officer magazine for its physicians leadership program with Baylor Health Care System.