At the same time hospitals purchase or partner with physician groups, other alliances break up or struggle to survive.
Often the key to success is strong leadership and a common vision, says F. Kenneth Ackerman Jr., vice president at consulting firm McManis Associates, based in Washington. Ackerman will discuss critical success factors for these partnerships in the HFMA session "Building and Integrating Medical Group Practices that Work," to be presented from 2: 30 to 4 p.m. Tuesday, June 22.
Physician groups have struggled to find viable partners, and hospitals often are the best answer, says Ackerman, formerly president and chief executive officer of Geisinger Medical Center, Danville, Pa., and senior administrative officer at Geisinger Health System.
"It's interesting that physicians have had their world turned upside down, and they've been running for cover and looking for a safe haven," he says. "They've tried insurance companies and failed; they've tried HMOs and failed; they've tried physician management companies and that sector is in trouble today. They haven't been as trusting with hospitals."
Despite an overall improvement in business relations between hospitals and physicians, most partnerships remain on a learning curve.
"It will be another five to 10 years before the majority are successful," he says.
For these partnerships to work, hospitals and physician groups must concentrate on building a structure designed to develop strong leadership abilities in both organizations, designing a joint vision and creating a new culture, Ackerman says.
One key is to find the right people to lead the governance board. "Often the board is too representational and not constructed to serve the entire organization," Ackerman says. "Or it's too big and too clumsy to make a decision. The board can become bogged down by operational issues and ignore strategic issues."
A strong partnership requires physician leaders as well as nonphysician managers who are well trained in administration and business. Good mentoring and a collaborative atmosphere can boost leadership training. "Mentoring by good physician executives who have a proven track record for success is a blessing for the young physician executives," Ackerman says.
If physician groups and health systems don't have that expertise, they can develop a leadership training program or collaborate with a local university.
"I'm a strong proponent of physicians and non-M.D. administrators working together in the classroom," he says. "It reinforces the concept of a physician/administrator team."
After building a strong group of leaders, the team must develop a shared vision, common goals, and outcome measurements and incentives that reflect those goals. "Those who want to bypass or shortcut the importance of a shared vision will never realize their potential," Ackerman says.
Together, the hospital and physician group must also create a new culture. "Often, hospitals impose their culture on the physician groups, and that doesn't work," Ackerman says. "You need a group culture, not a hospital culture."