Healthcare Executive - September/October 2013 - 74

On Physician Relations

that if the physicians are given the
same information as the executive
team, they will come to similar conclusions. Van Gorder says the pLC
does not even officially exist—it’s
not in any administration or medical
staff bylaws—but that doesn’t limit
its power.
“For the very first time, we shared
the decision-making process,” Van
Gorder says. “That group has
changed many times over. In 14
years we have accepted 100 percent
of the recommendations coming out
of that group, and only one vote has
been less than unanimous. It’s the
most formal, powerful, nonexistent
entity in the organization.”
The system Unitypoint created to
engage its physicians is two-tier: At
the local level, there’s a Regional
Quality and Clinical Integration
Committee, a Regional OSC
Leadership Council and a Regional
Finance and Network Development
Committee. At the system level, there
is a System Quality and Clinical
Integration Council, an Iowa Health
Accountable Care LC Board of
Managers and a System Finance and
Network Development Council.
“It was an important statement to
our physicians that this is the direction. This is where we want to be,”
Leaver says.
Educate Physicians
Both Unitypoint and Scripps have
established physician leadership academies. Unitypoint created its academy in 2010 in collaboration with the
American College of physician
Executives. Unitypoint created a customized curriculum for its physicians

Healthcare Executive
SEpT/OCT 2013

modeled off of ACpE’s and asked
physicians to apply to the academy,
which included a year of training and
100 to 112 credit hours toward a
master’s degree in business administration or medical management.
Unitypoint graduated its first class of
35 physicians in 2011, 39 in 2012
and expects to have 26 graduate in
2013. Leaver says the physicians’
energy and commitment to the year
of study, which included five full
weekends and significant time away
from their practices and families,
inspired him. “That spoke volumes to
me about their eagerness to change
what they do and their willingness to
transform what they do,” he says.
Scripps established its physician
leadership academy in 2011 and has
85 physicians enrolled this year. Van
Gorder says the academy is geared
toward rising physician leaders, and
the curriculum centers on managing
healthcare operations, as well as
leadership competencies and communication strategies.
Leaver and Van Gorder say that at
each of their systems, physicians
simply wanted to have a say in what
happened at their health system. No
economic incentives were given aside
from physicians sharing in the hospital savings. “I don’t know any physician that doesn’t want to be part of
a healthy business organization,”
Van Gorder says.
Provide the Focus
The approaches of Unitypoint and
Scripps are conceptually similar, but
each system went about integration
slightly differently due to organizational differences and federal and

state regulations. For example,
California is one of the few states
with corporate practice of medicine
laws, so Scripps has a medical foundation model in which physician
groups can contract with the foundation. It appears, from the outside
looking in, that the physicians are
employed even though they’re not.
Leaver and Van Gorder say healthcare executives seeking to align their
physicians must take the unique
characteristics of their local marketplace into account.
Leaver says integration is definitely a
journey that requires leaders to be
tenacious. “You, as executives, have
to provide that focus,” he told
Masters Series attendees.
“Ultimately, you will achieve something better for our patients.”
Van Gorder agrees patience is
required and asked healthcare leaders to educate their physicians, allow
the market to move a little bit, be
consistent and persistent, and then
“the whole thing will start to turn.”
“We are more physician driven and
controlled than ever before,” he says.
“And I think that’s a good thing.” s
Marisa J. Paulson is assistant content
editor with Healthcare Executive.
Editor’s note: ACHE recently created the physician Executives Forum
to provide additional resources to
meet the specific needs of physician
executives, including premier education, quarterly newsletters, an exclusive LinkedIn Group, career
resources and networking opportunities. Visit ache.org/PEForum to
learn more.

Healthcare Executive - September/October 2013

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