As part of the Foundation’s Physician Leadership blog series, we recently sat down with Docia Hickey, MD, President of the North Carolina Medical Society. Dr. Hickey, a neonatologist with more than 30 years of experience working across an array of practice settings, shares her thoughts on the current state of medicine, advice for young physicians and the competencies and qualities needed to become a physician leader today.
Q: What areas of physician leadership are not being talked about enough?
A: Physicians and, more broadly, the healthcare community talk a lot about the need to develop business skills. Yet, I don’t know if it’s resonating quite as much as it should. In the past, we used to laugh about physicians not possessing strong business acumen; now, more than ever, doctors need to understand the business side of healthcare. If you don’t, you will be left behind.
One key area that is not being discussed enough is the need to understand the regulatory dynamics driving policy change at the local, state and national levels. Policy plays a critical role in areas such as how you’re reimbursed, new quality reporting metrics, how you deliver care and so on. The reality is you need to be able make a living to pay your staff, and if you don’t understand how legislation is impacting reimbursement, you’ll have a very difficult time functioning in this environment.
Q: How does physician leadership change across hospitals, different practice settings, etc.?
A: Regardless of practice setting, physician leaders need to be able to listen, understand what’s going on, and be the person that serves as a liaison between the office staff and the executives. They need to be able to bridge the gap. A fundamental element that is core to any physician is to be an advocate for their patients, to make sure they don’t get lost in the shuffle of big business. Patients, and their families, is a foremost concern for physicians. We need to be there for them to ensure that their interests are always addressed.
Q: Healthcare is moving more towards quality metrics, risk arrangements and value-based care. What are your thoughts on these recent developments?
A: Value-based care should always be better for the patient. We have to ensure that physicians are making clinical decisions that are in the best interests of the patient, not making choices to simply save money. Someone only looking at the bottom line runs the risk of forgetting the most important aspect of medicine – delivering quality care to patients.
Ultimately, a physician leader is someone that understands the whole picture – both clinical and financial considerations. Sometimes, though, you need to spend more money to ensure the patient is cared for appropriately. We argue with insurance companies, Medicare, and Medicaid about cost-effectiveness, appropriateness of care, etc. The reality is people outside of the physician community don’t really get it; they can’t make these connections like doctors can.
Q: What advice do you have for younger physicians?
A: Younger physicians need to stay informed. Many do not understand the real positives of organized medicine. The reality is you can do a lot more, get involved more and be more aware of what’s happening in the healthcare business and regulatory environment.
For instance, when younger physicians are mulling over a contract offer, they should not blindly sign the contract. When I had residents, I used to tell them, “don’t have your cousin, next door neighbor or whomever review this contract.” Go to an expert and have them evaluate the contract closely to ensure you’re not getting roped into agreements that have restrictive non-compete clauses, problematic payment structures, among others.
On a different note, my advice to residents is independent of medicine, find something in your community that you can be involved in. Pursue your passions and become a leader in your community, whether that is in the form of charity work, becoming active in your local church, etc. Bottom line: It makes you a more whole person and grounds you significantly.
A big thank you to Dr. Hickey for sharing valuable thoughts and insights on the state of physician leadership.