Why Physician Leadership Matters and What We’re Doing About it in Eastern Massachusetts

November 16, 2018

At New England Quality Care Alliance, we pride ourselves on being a patient-focused and physician-led organization. As the CEO of this 1,700 partnership of doctors and a third generation primary care physician, I can tell you that’s more than just a catchy tagline or a promise we make on our website. It’s how we operate.

Michele Crage, a practicing nephrologist, member of our Board of Trustees, and President of Highland Healthcare Associates, IPA, has called NEQCA the last regional network standing where the physician still matters. And I think she’s right in her assessment.

While other systems of care claim they value physician input or having ‘a physician voice’ in their operations, we differentiate ourselves by having doctors serve in our organization’s most senior leadership positions. 19 of our 21 Board of Trustees seats – including the Chair – are filled by doctors, and doctors chair our Contracting, Governance, Performance, Finance and Audit, and Funds Flow Committees.

Why is that important?

Having physicians in leadership positions helps to ensure that we never lose sight of patients,  the people whose health we work every day to protect and improve. It also ensures that we have a much more direct line of sight into the many challenges facing caregivers, and that we can help support, sustain, and create the kinds of practices they want to work in – both today and in the future.

Ted Herwig, a practicing primary care physician, President of Cape Physicians LLC., and Chairman of NEQCA’s Funds Flow Committee recently said, “If it weren’t for NEQCA, our solo and small practices would all be out of business.” Founded in 2005 by Tufts Medical Center and Primary Care, LLC, the NEQCA network includes single physician and group practices, independent practice associations, physician hospital organizations and academic and community physicians. There’s nothing else quite like it in Massachusetts. Many of our affiliated practices are comprised of only one or two physicians and many are self-employed.

So what is it that makes a network like ours so special? And why is it important to build and strengthen the leadership skills of physicians who are calling the shots, not only in the exam rooms, but also in the Boardroom?

Our view on physician leadership, which is shared by our parent company, Tufts Medical Center, and its parent, Wellforce, is that our organizations’ strategic direction - and increasingly, the implementation of initiatives related to that direction - should be led by people who have dedicated themselves to caring for patients. While that’s something we believe is a major differentiator for our network, and that we’re very proud of, it’s also a source of some concern.

In their recent New England Journal of Medicine article, Leadership Development in Medicine, Caryn Lerman and J. Larry Jameson tell us that “healthcare in the US suffers from a persistent and worsening disconnect between the capacity of the physician-leadership workforce and the needs of our expanding and increasingly complex health systems.” They go on to say that closing this gap will require leadership skills that are not acquired during traditional medical training.

At NEQCA, and throughout the Wellforce system, we believe it’s important for the people who have the greatest potential to make the most meaningful and positive impact on their patients’ health and lives to be a major part of shaping and running the healthcare businesses they are part of. But most of these current and emerging leaders are not businesspeople. And, because we don’t employ the vast majority of our affiliated physicians, it’s not an option for us to just hire in these skills. While others lament this problem and wring their hands about what to do, we’re making an investment in identifying and growing our own leaders.

In partnership with East End Associates, we developed and piloted the NEQCA Leadership Academy – a program designed to strengthen business and management skills and build foundational leadership capabilities in current and emerging network leaders. The six-session program, run on Saturdays over a six-month period, connected 31 of our network leaders with internationally acclaimed faculty members across a variety of leadership and management disciplines and provided continuing medical education credits and a certificate in healthcare leadership. 23 members (74%) of this first cohort were physicians, and the program assessment results were very high.

  • 100% of cohort members reported that they were satisfied or very satisfied with the program.
  • 100% said the program provided knowledge and leadership skills that would make them more effective in their current and future roles.
  • 100% said that we should continue the program and that they would recommend it to a colleague.

Based on these scores – and other equally positive qualitative feedback – we’re planning to repeat the program in 2019 and have just announced the 29 members of our second cohort.

Why does this matter?

As more consolidations of hospitals and health care systems are approved, creating a smaller number of larger mega-systems and fewer networks to choose from here in Massachusetts, NEQCA, Tufts Medical Center, and Wellforce are keeping our focus on providing the high-quality and lower cost care our State needs and its patients demand and deserve. We’re also working to keep the most important care decisions in the hands of physicians and helping to better equip our physician leaders to make the best business and strategic decisions to ensure the ongoing success of their practices, their local care organizations and the network. I am convinced that this is a meaningful and significant differentiator for us, and it’s an effort I am proud to help lead.

Joseph P. Frolkis MD, PhD, FACP, FAHA is President and CEO of New England Quality Care Alliance