Leadership and Management Training for physicians

Maria V. Gibson, MD, PhD Trident / MUSC Family Medicine Residency Program

Background Practice Problem Solving Team

Limitations

Objective

• Until 2006 family medicine residents were offered AAFP proposed didactic curriculum in the form of lectures Feedback from two years of graduating residents revealed that 19 from 20 were lucking hands on leadership experience.

• Aim for development of combination of hands on leadership, communication and team building skills with knowledge of current health care reform and management during residency training.

• Suggest a stepwise approach from medical student to residents and to practicing physician leadership training

• Finish the Leadership and Management skills for physicians survey for physicians, faculty, students and residents

• Based of the results create a Leadership and Management training for medical students, residents and faculty at the Medical University of South Carolina

• Survey Leadership and management skills for physicians: when and how was posted on ACPE network “ Ask ACPE anything”. 58 ACPE members responded to the survey. 90% of them suggested that Leadership and Practice Management should be taught in graduate school

• New Leadership and Management curriculum was developed in 2007 at the Trident /MUSC Family Medicine Residency Program. It included Leadership and Management for physicians” didactic training combined with Resident Medical Directorship hands on leadership experience.

• Traditional AAFP recommended practice management curriculum for family medicine residents “From residency to Reality”, includes didactic modules of business operations, planning, risk management, health information technology, office roles and staffing, quality measurement and improvement, regulatory issues, and vendor relationships.

• There is a gap between didactic courses of graduate school and requirements for practical leadership skills necessary for physicians practicing within Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH) during current health care reform.

Leadership and Management Training Model

Future Directions

• Due to specifics of “ Ask ACPE anything” network only limited number of ACPE members responded to the survey

• Training Model was implemented only at the Trident/ MUSC Family Medicine Residency Program

Methods

• To assess ACPE members perception of leadership and management training for physicians.

• . Develop leadership and health care management curriculum for Family Medicine Residency training that would fit current needs for primary care physicians.

Discussion

2010-2012 Residents Practice Problem Solving Team ( PPST) projects implemented at the Family Medicine Center:• Chronic pain management registry• Optimization of chronic pain management• Utilization of new UDS screen for chronic pain management patients• Clinic efficiency: utilization of nursing resources• Monitoring of patient flow• Optimization of well child exam• Utilization of resources for patients with ADHD• Medicare wellness exam implementation• Preventative care for patients with chronic medical problems• Analysis of billing pattern for Diabetes visits • Group visits implementation• Apprentice model of precepting

• Resident Medical Directorship of the month:• Daily outpatient Family Medicine Center business operations,• rounding, communication with the staff and patients, staffing,

Quality improvement and measurement, business meetings and teams leadership.

• Practice Problem Solving Team ( PPST) project for finding• solutions for existing problems in the clinic based on Lean Six

Sigma methodology and evidence from “ best practices”• Physicians performance training and Contract negotiation• simulation sessions• Leadership style evaluation and team building skills development• Marketing in health care• PCMH certification instructional training• Quality measurement, improvement based on NCQA/ADA and• NCQA/AHA physicians recognition Diabetes and  Cardio-vascular• disease Programs training • AAFP Recommended didactic reading materials

Preliminary Results of survey

Top 5 topics to learn for physicians For leadership and practice management training•Patient safety and quality•Communication and conflict resolution•Physician performance•Financial decision making •Information technology

Top 5 topics to learn for physicians For leadership and practice management training•Patient safety and quality•Communication and conflict resolution•Physician performance•Financial decision making •Information technology

Top 5 best ways to learn leadership and practice Management for physicians• Experience• Individual and group coaching• MBA, MHA and other business degrees• CME after the appointment to a leadership position• Rotation during residency training

Top 5 topics to learn for physicians during residency Training about leadership and practice management•  Patient safety and quality• Billing and coding• Communication and conflict resolution• Physician performance• Information technology

Suggestions: gibsonmv@gmail.com