Turning Hospital-Physician Conflict into Collaboration

Physicians as a group could be characterized as morose over the anticipated shift in the future organization of healthcare: from changing reimbursement models to the trend toward hospital-physician alignment in accountable care organizations.  However, instead of waiting passively, physicians can proactively embrace new ways of collaborating with hospitals and health systems and plan for the change they want.

This topic is the subject of one of this year's educational sessions at MGMA12 in San Antonio on Monday, October 22. "Four Tools for Turning Hospital-Physician Conflict into Collaboration" will be presented by practice management consultant Kenneth Hekman, president of The Hekman Group based in Holland, Mich. Hekman spends most of his time working with physician-owned groups, many of whom are concerned about avoiding or smoothing the transition into hospital-integrated delivery systems.

While Hekman says that the "jury is still out on whether it is possible to merge, but not
merge," he notes that becoming a stronger organization has an intrinsic value to physician groups.  

"If you think about structures and financial incentives as the skeleton of the body, I'm talking about the muscle and the tendons," he says. "[It's] the stuff that enables a healthy organization to move and adapt and stay agile in a changing environment."

Physicians who attend Hekman's session will learn to identify the risks and benefits of physician/hospital collaboration; how to adapt four tools for building trust between these groups; and also use these tools to foster collaboration.

"The four tools are born out of more than 20 years … helping [physician groups] become stronger organizations in and of themselves," Hekman says. "And some of the tactics and techniques that I've developed over the years, I think have equal value in transitioning groups into hospital settings."

The first of these tools is "values mapping," which Hekman says uses sociological research methods to quantify the value differences between independent physicians and hospital executives. Identifying ideological differences is useful to "identify the gaps, so we can start to manage the gaps," he said.

The next tool is "polarity management," which allows physicians to identify intractable value differences. Developing a polarity management map, using a four-quadrant model, gives physician groups a way to quantify and define value differences. "The polarity management map gives us a technique for putting that value discussion on paper and really figuring out how we can manage this polarity rather than try to solve it as a problem," Hekman says. He gives this example: "Should we concentrate on the mission or should we concentrate on the margin? Well, the answer is both. You have to manage both of those [simultaneously]."

The third tool is "leadership coaching." Hekman notes that even though this is not a new technique, it is less utilized in physician groups than in other executive environments. He says it should not be viewed as a way to fix people, but rather "we are trying to help them use their talents to their best, and build those skills and talents for leadership."

The last tool is "cultural intelligence," otherwise known as cultural quotient or CQ. Hekman says it is a learned intelligence that is drawn from international studies; one that can help people become more effective working across different cultures. "In the last 10 years we have figured out ways to help people become effective working cross-culturally. Sometimes the difference between the hospital culture and physician culture is as different as North America and Europe. Or as different as Venus and Mars."

With all the changes - current and pending - in healthcare, Hekman notes that "we are in an extraordinary moment in history."

"And you can't just use the techniques of the past… and expect to get the same results," he says. "This time we have to look at new techniques for improving behaviors, changing behavior. And that means our own behavior as well as the behavior of others. …I'd like to give people some tools so that they can turn conflict into a positive force, rather than a negative one."

This session will be available for purchase, on demand, after the MGMA12 conference ends. For those who attend the session in person, there will also be a free download that offers a sampling of values mapping surveys.