Developing a true partnership with physicians.

As anyone who has ever attempted it knows, building a partnership is a challenge. To build a successful partnership, one must be acutely sensitive to others' needs while keeping one's own concerns and goals in mind. A successful partnership is a balancing act that demands energy and empathy. And

Financial executives of healthcare organizations must continually make efforts to reach out to the organization's most essential professional partners - the physicians who admit and treat patients. Developing a true partnership with physicians may not be easy, but it is vital.

Understanding Physician Concerns

Physicians are enduring anxious times, in part because the very skills that make them excellent clinicians may be hampering their ability to work within the new business realities of the healthcare industry. Physicians' focus on patient care, for example, requires them to be highly skilled in gathering and assessing facts, making decisions, and managing crises. Physicians must be able to take charge of situations and select patient treatment protocols based on a solid understanding of scientific principles and established standards of practice. The confidence and decisiveness physicians must have to perform their work make them independent and sensitive to "interference," especially when it involves the way they practice medicine. In addition, physicians' scientific orientation makes them interested in quantitative solutions and less tolerant of what they might perceive to be the "soft" management strategies that have gained prominence in recent years to deal with such business issues as cost containment and competition.

Therefore, physicians may be less likely to intuitively buy into management initiatives that promote cooperation and teamwork. In addition, they may be less comfortable with healthcare administrative functions that focus on ensuring quality processes as well as performance.

Because physician buy-in is vitally important to the success of the healthcare organization's mission as a whole, financial executives must be prepared to secure it. They must be able to explain to physicians in detail how new management objectives and methods dovetail with quality care and the overall financial success of all partners in the healthcare organization.

Improving Communication

Healthcare organizations and physicians do not have incompatible interests; indeed, each needs the other more than ever as reimbursement continues to shrink and competition grows more fierce. In order for physicians and healthcare executives to operate as partners, it is important that their interests and goals be aligned.

Financial executives are uniquely positioned to reach out to physicians and work with them to build the communication bridges that must exist if a true partnership is to be established. Those who believe financial executives lack the communication skills needed to reach and influence physicians may see them only as bean-counters who are focused on the past. The financial executive of today is an individual with strategic vision, scope, and broad, deep experience who not only sees but can elucidate "the big picture." Perhaps more than anyone else in the healthcare industry, financial executives understand where healthcare organizations are now, where they need to go in the future, and what it will take to get there. Financial executives are the ideal people to earn physicians' respect and trust by sharing their vision.

The key to communicating with physicians is the ability to integrate financial concerns and clinical concerns. Physicians are accustomed to viewing results within acceptable parameters, so it might be helpful to discuss with them the results that are needed (the parameters) and then involve them in determining how performance will be measured against those results. Physicians are very savvy about interpreting data, so it will be easy for them to understand how their interests intersect and align with those of the organization.

It is equally important for financial executives to understand and appreciate physicians' clinical issues and concerns because only by doing so can they understand how to align interests in a way that will create stronger, more effective healthcare organizations. Financial executives should read periodicals of interest to physicians, make presentations at physicians' meetings, and attend educational programs that explore physicians' viewpoints. Above all, financial executives should talk with physicians regularly and listen to their concerns.

It is vital that financial executives and physicians deal with each other clearly, honestly, openly, and factually with the aim of making needed organizational improvements, negotiating advantageous contracts, and presenting a unified front when interfacing with other healthcare entities and the business community. Randy Christophel, CFO at Goshen Health System in Goshen, Indiana, said it best: "I see a significant role for the CFO in helping to facilitate the alignment of interests of the organization and associated physicians. It's less about how interests 'should' align and more about how they do align in actual practice. Partnering with physicians is an evolutionary process that has no finish line; we are working toward goals together."

Michael F. Doody, MPA, is senior vice president, Witt/Kieffer, Ford, Hadelman & Lloyd, Oak Brook, Illinois. He was president and chief executive officer of HFMA from 1983 to 1986.