In my first publisher's letter, I vowed to use this forum to identify physician executives who are making a difference and share their stories with you, our readers.
One way a physician executive can make a difference is by taking on a thankless task or fighting an uphill battle. William Jacott, M.D., who is determined to upgrade the image of the Joint Commission on the Accreditation of Healthcare Organizations within the physician community, is a case in point.
The former Duluth, Minn., family practitioner truly believes that the JCAHO can serve a valuable role in reducing medical errors and improving the quality of patient care. That runs counter to the prevailing attitude of many physicians who view the JCAHO as little more than a combination meter maid, building inspector and tax auditor.
"Physicians usually kick and scream when they realize it's time for a (JCAHO) site visit," says Jacott. "I want to help them understand that the organization is about more than counting fire extinguishers and measuring dry, technical standards."
Jacott, 63, has served on the JCAHO board since 1992 and was board chairman in 1999 and 2000. But he hasn't always been a cheerleader for the Oak Brook, Ill.-based accreditor. He also served on the AMA board from 1989 to 1998.
In the mid-1990s, he led an AMA crusade designed to streamline the accreditation survey, with an expanded focus on quality measurement. At the time, he blasted the JCAHO for sticking with a "cumbersome, costly and inefficient" process that focused on punitive action rather than education and quality improvement.
"I'll never forget the time a surveyor scolded us at the University of Minnesota because a locked-down psychiatric unit didn't use Phillips screws on its bathroom doors," Jacott says. "He insisted that patients could escape by using a dime to loosen the standard screws."
But times and attitudes have changed, he says. He cites the JCAHO's sentinel events reporting program, the Oryx initiative to integrate performance measurement data into the accreditation process and a continuous survey-readiness strategy that helps providers operate as if each day were a scheduled inspection.
"We finally have a story to tell physicians," Jacott says.
It was during his tenure as chairman that the JCAHO board agreed on a set of strategic priorities, including physician outreach.
The first thrust will begin in January with a series of meetings with medical societies, specialty associations, chief medical officers and other influential physician executives.
"I need buy-in from physician leaders," Jacott says. "The enlightened ones realize managed care's power is slipping and physicians have regained leverage."
The chances of maintaining that power will be predicated on the ability of providers to reduce medical errors, improve quality and keep healthcare costs in line.
Modern Physician is dedicated to providing readers with the type of information that can help in the effort. We also will continue to spotlight the physician leaders who are making a difference.
If you know an executive, entrepreneur or clinical manager who fits the bill, please send me a short description at [email protected]
Clark W. Bell