Seeking Out the C-Suite
As health care shifts, now is the time to establish relationships with your system leaders.
Radiologists are interacting more broadly in their health systems, and they shouldn’t forget the health system’s leadership, which includes titles like the CEO, CMO, and CFO (hence the term “C-suite”).
By offering support to, and engagement with, these leaders,radiologists can further position themselves not only as imaging service experts, but also as strong potential partners in the shift from volume- to value-based care. The American Association for Physician Leadership explains how radiologists can inform top-level decision-making and support the C-suite in pursuing quality patient care.
In many health systems, there is a misconception that excess imaging utilization is driving up costs. Radiology services are not always viewed in the broader scope of the health care system. By collecting specific health care information and pairing it with data on national imaging trends, radiologists can help their leadership place the value of imaging within the context of the wider health care delivery system.
When it comes to decision-making, information is power. Radiologists have access to huge amounts of data about ordering patterns, quality of care, and imaging utilization. To get significant attention from the C-suite, radiologists should prioritize collecting, synthesizing, and communicating these data in a way that accurately portrays the imaging services in the system.
As we’re collecting data, we tend to focus on the outliers, both on the negative side and the positive side. The positive outliers can often be emulated for best local practices and they can serve as ambassadors for efforts to improve performance overall. But the greatest results come when we focus on the middle of a normal, bell-shaped distribution of outcomes. We need to help the entire group move toward higher value. That is not to say that we should ignore the negative outliers.
Some of these physicians do not even realize that they are outliers. Once we’ve identified the issue and responded with image-ordering education, most will improve their performance. Others know that they are outliers and will choose not to change their behavior. These individuals may benefit from mentoring, counselling, or incentives. Some may choose to change jobs rather than modify their behavior.
As 2017 approaches and health systems continue to implement clinical decision support (CDS) systems, one of the biggest obstacles they face is simply the power of habit for clinicians, radiologists, and administrators. And each group will need to find ways to make changes to their processes in order for these tools to have their full effect.
When it comes to decision-making, information is power.
Clinicians are accustomed to ordering imaging studies one way, and CDS asks them to alter their habits to another. If we can successfully embed these tools in the electronic health record, physicians will be able to better ensure they are ordering the correct study without accessing a separate system. By making this process more efficient, we can help clinicians be more willing to adopt this habit. Radiologists should be a large part of this transition as they interact with their clinical colleagues and emphasize the value and utility of these radiologist-developed tools. This is an opportunity for radiology to support both clinicians and patients by ensuring that the most appropriate imaging study is performed for the individual situation.
Radiologists may also need to change their habits in order for CDS to really take hold. Currently many radiologists become involved in imaging only when the study comes across their work list. Radiologists need to make themselves available for pre-imaging consultation. That doesn’t just mean picking up the phone when a referring physician calls. It means reaching out proactively to say, “Please let me know how I can support you. Don’t hesitate to call me if you have a question while you’re ordering a study.”
Administrators may also need to reevaluate some of their habits. Leadership often views radiology as a resource-intensive area without opportunity for much improvement. They don’t realize how appropriateness criteria and CDS tools change ordering patterns and maximize the value of the imaging performed in their health system. It will be up to radiologists to provide information about these tools and aid in the implementation at the system level. The net results should provide increased efficiencies and appropriateness of imaging studies.
At some level, all physicians are leaders — and society still expects this to be the case.
Radiologists have historically not participated heavily in administrative activities, and that’s an area where they should get involved, especially in activities related to quality improvement. If we are going to have a value-driven care delivery model, then we need to look critically at imaging. And radiologists are the imaging experts.
Is it a challenge to jump straight into health system involvement? Sure. The changing world of health care delivery is complicated. To be successful, you need to gain leadership skills and experience while you cultivate a concrete understanding of how your system functions.
This is true for radiologists, but it’s also relevant for all clinicians. More physicians need to acquire management and leadership skills to better effect change in their systems. You can learn these things by doing them and also by enrolling in training programs. Start small. Find a committee you are interested in and to which you feel you can contribute. Then go from there.
You may find that the management of a health care system or even a group practice is more complicated than physicians realize. Of course there are financial pressures, but systems must also balance issues related to regulation, policy, insurance, patients, and staff. All of these factors exist in the current reality, where financial margins often reach only 1 or 2 percent per year. The administrators and the C-suites are not trying to block the physicians from improving. They are working to set priorities in a complex environment.
Engagement and integration of physicians in evolving clinical delivery models is currently a priority for nearly all hospitals and health systems. Radiologists have a unique opportunity to provide insights and leadership for a traditionally resource-intense segment of the delivery system. The timing is optimal to become engaged and to help create significant change in your local or regional delivery system.
Meet the American Association for Physician Leadership
Since 1975, the American Association for Physician Leadership has fostered management and leadership skills for physicians and encouraged them to assume greater roles in the delivery of health care. Today the organization represents chief executive officers, chief medical officers, vice presidents of medical affairs, medical directors, and other physician leaders from more than 45 countries.
Imaging 3.0™ in Action
Learn how to present actionable data to your C-suite.
By Peter B. Angood, MD, president and CEO of the American Association for Physician Leadership