James A. Greer, Jr., MD, MBA Medical Director Ochsner

James A. Greer, Jr., MD, MBA Medical Director Ochsner Clinic Foundation Baton Rouge

Medical Profession Ethics Law Business Administration

Healthcare Trends Changing Patient Demographics Changing Workforce Consumerism Technology Genetics Quality Patient Safety Tort Reform Baby Boomers Impact Uninsured Population Insurer Consolidation Specialty Hospitals

Local Market Trends Charity System Medicaid Funding Physician Competition with Hospitals Specialty Hospitals

Resources Manpower Materials Machines Money Methods Marketing

Group Practice Tasks Physician Manager Administration Tasks of Both

Clinicians Doers Managers Planners, Delegaters 1:1 Interactions 1:N Interactions Reactive Personalities Pro-Active Personalities Deciders Expect Delayed Results Value Autonomy “My Judgment” Value Collaboration “Our Team” Patient Advocate Organization Advocate Tolerates System Committed to System Authority of Knowledge Authority of Position Resents Rules Promotes Rules Optimizes Controls “What is best?” “What will do?”

Physician Manager Tasks Maintaining Quality Innovative Adequate Work Effort Retention Adequate Compensation Plan Recruitment Personnel Issues Dealing with Exceptional and Problem Physicians External Relationships Developing Future Leaders

Tasks of Physician Manager and Administrator Customer Satisfaction Strategic Direction Marketing Communication Fee Schedule Allocation of Resources Culture of Group

Personnel Issues/Physicians Evaluations – Patient Satisfaction, Competence, Relationships, Practice Data Impaired Physicians – Medically Incompetent, Personality Problems, Substance Abuse, Sexual Misconduct Physician Management of Non-Physician Personnel

Physician Compensation Allocation for Physicians – Payout vs. Retained Earnings Allocation to Physicians – How to Distribute? – Gross Charges, Revenue, RVU’s, Equal Distribution, Other Subjective Components

Strategic Planning What’s the future and how do we get there? Growth – Natural or Planned? Capital Needs Planning Changes Branches

Information Systems Cost User Friendly Flexible Integrated Database Easy to Maintain

Information Systems PACS EMR

Managing Professionals Realize Peer Pressure Sell Input Use Facts/Knowledge Communicate the “Big Picture”

The Business Plan Executive Summary Market Analysis Company or Group Description Organization and Management Marketing Plan Service or Product Line Funding Request Financial Statement Appendix

Challenges Managing the Professionals Managing the Cost/Q Tension Positive and Negative Interactions Balance of “Physician & Manager” Advocate of both Physicians and Organization

Lessons Learned Practice Medicine Assume People Will Do Their Best Persuade, Not Dictate Prepare for Meetings (Over) Communicate Relationships & Colleagues – 1st: Patients – 2nd: Organization – 3rd: Individual Involve Physicians with Decisions – They always raise issues Satisfaction is Different