ADMINISTRATION
Clinical Service Lines A training ground for the emerging physician leader DANIEL K. ZISMER. PH.D.
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he demand for trained and experienced physician leaders is increasing at an accelerating rate domestically and internationally, and opportunities for physician leaders are no longer isolated to the C-Suite of health care organizations, or larger medical groups. Likewise, these job openings are no longer reserved for the physicians who may have matured into the twilight years of their career, or physicians who must abandon clinical care in favor of full-time medical administration. Experience with the Health Care Administration Program, University of Minnesota identified growing interest from younger, practicing physicians in developing competencies in a parallel career; healthcare management. By the third year of the newly launched Executive MHA program, it was clear that physicians at mid-career and less, whether domestic or international, came to the program with unapologetic enthusiasm for their desire, as one young physician put it “to develop a different part of my brain”. Another, a young interventional radiologist, by his mid thirties, had already decided that he “did not want to go through the rest of his career wearing a lead apron”, and a third interviewed for admission to the program had stated that “I want to provide myself options as my medical career unfolds”.
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As physicians consider a career in organizational leadership there are typically two questions that loom large. Both are addressed here. The first is “will I need to eventually give up the practice of medicine to succeed?”, the second “is there a reasonable, more measured way to get started on the path?” The answer to the first is easy. No! There are a number of leaders who effectively navigate roles as clinicians and as leaders in health systems and medical practices, while some do decide to hang up their stethoscopes in favor of an alternative way to contribute to patient care, and healthcare delivery more broadly. The second question presents the centerpiece of this article: “is there a manageable way to get started on the path of becoming a physician leader?” The answer to this question is represented by a fast expanding opportunity for physicians who wish to get their feet wet with a meaningful role in leadership without jumping into the deep end of the pool. That opportunity is serving as the physician member of a “leadership dyad” in charge of a clinical service line within a health system or medical clinic. In a chapter written for Mechanick and Kushner’s 2020 book titled “Creating a Lifestyle Medicine Center” (Zismer, D.K.) a clinical service line is described as “a grouping of defined clinical services and programs dedicated to an identified constellation of related diagnoses, and clinical conditions, designed and dedicated to produce superior course of care, over time, based upon evidence-based, best practices for defined clinical populations”. Clinical service lines are often, but not exclusively, dedicated to the management of chronic diseases and conditions. The clinical service line “leadership dyad” pairs a practicing physician leader with a trained administrative services partner to oversee the design, leadership and management of the clinical service line. The physician partner in the dyad has a defined, part-time job. The position is typically responsible for providing the clinical guidance to how, and how well, the clinical service line functions and performs its obligations to patients served, including how providers work as teams to enhance clinical outcomes, and how clinical and staff resources are applied to create optimal outcomes. To be clear, the leadership dyad is not two people doing the same job. The physician and administrative dyad partners bring unique skill sets and competencies to the leadership of the service line.
A Model for Shared Leadership But are clinical service lines a real and sustainable strategy worthy of redirection of a physician’ career path? In a survey of 47 health systems conducted by Wegmiller and Zismer, 85% of systems in the sample stated they had already launched, or expected to launch one or more clinical services as principal components of an overall organizational strategic plan. Most health systems in Minnesota have long since decided to compete based upon what are easily identified as clinical service lines including; “heart and vascular centers”, “sports medicine”, “mother and baby hospitals”, “pain management centers”, “behavioral health programs”, “lifestyle and wellness centers” and “diabetes management programs” to name a few. So if starting on the path of physician leadership can begin as member of clinical service line dyad, what does the emerging physician, with little Clinical Service Lines to page 224
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MARCH 2021 MINNESOTA PHYSICIAN
