“Doctor, you need to see more patients.” Too often these days physicians hear this from their CEO or CFO and think, “I can’t do any more without cracking.” In a recent post directed to CFOs I discussed the financial impact of burnout on hospitals and health care systems. Physicians are cracking under the strain. Today’s post is directed to both physicians and CFOs, because both can benefit from investing in redesigning care delivery, maximizing ROI (Return on Investment) in their areas of greatest concern. For physicians, while salary is always important, more of us are reducing our patient loads in order to regain much-needed work life balance and stay sane. For CFOs, as the impacts of whatever happens with health care reform increases uncertainty, improving productivity is a key to weathering the oncoming financial storms.
Maximizing ROI Requires Making an Investment
OK, this seems pretty basic, at least for MBAs who have invested their own time (and often their own money) getting educated in business, finance, and accounting. They have made this investment with an expectation of a return consisting of a better job, or a better ability to perform their job. Physicians have invested a decade of their lives with an expectation gaining the knowledge and experience needed for patients to trust them with their health. So the concept of expecting a return on an investment is shared by CFOs and MDs. If we made the investment, then maximizing ROI makes sense.
Can CFOs and Physicians Find Common Ground?
Primary care physicians generate $1.5M in revenue for the hospital they are affiliated with. If they reduce their workload by 20% to maintain work life balance, they regain work life balance with the downside of reduced personal income. For the hospital, this translates into a $300K reduction in revenues. It’s a no-brainer for CFOs to invest $50-100K if it returned $300K. That’s are ROI of at least 3:1.
Physicians are reluctant to invest their time in activities that could improve their efficiency and work life balance without reducing their patient load. When we ask physicians to participate in huddles for 15 minutes a day, or worse yet, to participate in a week-long Rapid Improvement Event, many will complain that it will take them away from their patients, reducing their income and hurting patient care. They have good reason for concern, as prior initiatives coming from administration and promising to improve quality, service, or productivity have often made things worse for physicians.
Redesigning Around Team Care as Common Ground
The growing movement of team care provides the opportunity for common ground – for CFOs to invest in additional support staff for physicians, and for physicians to invest their time in redesigning their work to use the additional support staff effectively. Surrounding an office physician or a hospitalist with a team makes sense.
No surgeon would start an operation without a team there for support. The surgeon can’t provide anesthesia, be handed the right instrument at the right time, and manage the rest of the patient’s needs while also focusing on the procedure effectively and performing it efficiently. Yet as cognitive care has gotten more complex, we have been slow to add support staff who can do the same for physicians who could focus more effectively on their patient and provide care more efficiently, if their time was spent performing at the top of their license,if they weren’t clicking away at a keyboard entering data, and if messages were teed up for them effectively.
Here are a few options to learn about team care, there are a number of others that are easily found on a Google search.
- The AMA STEPSforward site on team-based care,
- Bellin Health has education on team care,
- Team Care Medicine provides a training program on site to assist you, and of course,
- Simpler Healthcare has significant experience in transforming practices with team care, including the transformation of Sutter Gould Medical Foundation when I was the CEO.
Will You Make the Investment?
The key is your willingness to change. Will you, as a CFO or as a physician, be willing to invest dollars and your time to improve your financial and personal bottom lines. Can you see that pursuing a common investment can achieve success on seemingly differing goals? If not, I’d ask you, “Why not?” What we are doing now is not working.
Have you had experience with team care? If so, what worked and what didn’t? Please share by clicking here to enter a comment.