Challenges the same, regardless of settingI enjoyed your feature on hospital administrators jumping over into running physician practices (March 5). After 23 years in hospital management, I made that jump in 1995, becoming the chief executive of a 50-physician multispecialty group. I spent three years there before returning to the hospital business. I found so many parallels between the two types of organizations that it is difficult to enumerate them. Both environments deal with essentially the same issues: diminishing payments and threats from insurers; cutting overhead; increasing market share; implementing intelligent strategic plans; responding to regulatory threats; and providing customer-friendly patient care. The complexity of the group practice operation is just as great as the hospital’s, and, as noted in the story, perhaps more so because of the need for the practice administrator to deal effectively with physician owners who have a much more significant stake in their business success than most hospital executives have in theirs. While my group, like many others, was organized as a corporate entity, it was difficult for many physicians to appreciate the need to collaborate with one another to ensure organizational success. Many times they worked independently of one another, which undermined their efforts to achieve their overall goals. That was the most frustrating aspect of medical group management. Surprisingly, my transition from hospital to medical group went much smoother than I anticipated. I found that some physicians were suspicious of a former hospital administrator but it generally wasn’t a handicap in working effectively with them. It felt strange the first time I met with our local hospital officials in negotiations, but I certainly knew which side I was on and why I was there.
Viewing the hospital as the "dark side" took some adjustment, but I felt my mission was to try to teach my group about how the hospital works and to have a better appreciation for the positions taken, which often were misunderstood or looked on with deep suspicion.
Working in medical group management was probably the most enjoyable job I’ve had in my 34-year career. I think it was because I had greater responsibility for decisions and a more immediate effect on the outcome of decisions than I had experienced to that date.
Paul ScopacChief operating officer Oneida (N.Y.) Healthcare Center Respect physicians as ‘servant leaders’ I thought Michael Romano captured many of the key elements that I found in my transition from managing hospitals to managing group practices (March 5). However, I am not sure he noted the need to genuinely enjoy working with physicians on issues of their concern. The term "servant leader" comes to mind as I work to meet their needs and the needs of our patients, staff and the greater community. In that regard, the change has been the right one for me.
Craig BakkenAdministrator and chief executive officer Rocky Mountain Gastroenterology Associates Rocky Mountain Endoscopy Centers Lakewood, Colo. Making the move shouldn’t be a surprise After getting a master’s degree in health administration, spending 10 years in hospital administration and another 18 years in medical practice management, I found your feature about senior hospital executives moving to medical groups a fun read (March 5).
I disagree, however, with reporter Michael Romano’s premise that this is a remarkable phenomenon. The reasons for such a change are no more remarkable than the challenge of entrepreneurial success, equity ownership or the desire to make a difference for physicians you like.As in any professional endeavor, all of these reasons demand hard work, preparation and self-confidence to be fulfilled. Anyone who chooses group practice management as a "bailout" from hospital administration will find a hole in his parachute.
James PerkinsAdministrator West End Orthopaedic Clinic Richmond, Va.