Author + information
- Shalom Jacobovitz, Chief Executive Officer, American College of Cardiology∗ ()
- ↵∗Address correspondence to:
Shalom Jacobovitz, American College of Cardiology, 2400 N Street NW, Washington, DC 20037.
I am a self-proclaimed business and management philosophy junkie. My shelves are full of books on achieving flawless execution, innovative strategies for modern business, and examples of empowered organizations. These rich sources of case studies and real-life examples are important tools not only for me as chief executive officer of the American College of Cardiology (ACC), but also for staff and College leaders as we move forward with our strategic efforts to position the organization as the professional home for each and every member of the cardiovascular care team.
One of my favorite and frequent sources of inspiration is the Harvard Business Review. Much like JACC is for cardiovascular professionals, the Harvard Business Review provides me with insights from leaders across the business spectrum from health care to software to fast food. Recently, a June 2014 story on “Engaging Doctors in the Health Care Revolution” by Thomas H. Lee, chief medical officer at Press Ganey, and Toby Cosgrove, chief executive officer of the Cleveland Clinic (1), caught my eye for its inescapable parallels to what the ACC is hoping to accomplish both at an organizational level and at a broader level in the healthcare community.
It is clear that health care is changing. The environment that physicians practice in today is markedly different from the way it was just a few years ago, let alone a decade ago. Between new certification requirements, expansion of health information technology, new reimbursement and care delivery models, hospital integration, workforce fluctuations, and changing physician/patient dynamics, cardiovascular professionals are faced with a drastically evolving practice landscape. Given these and other sweeping changes, Lee and Cosgrove stress the need for physicians to play a central role in fixing health care and undertaking a “radical transformation” that moves us “from a system organized around individual physicians to a team-based approach focused on patients” (1).
However, they note that getting the physician community to the table poses a challenge. “Many physicians are deeply anxious about the changes under way and are mourning real or anticipated losses of autonomy, respect, and income,” they write. “They’re moving at various rates through the stages of grief: A few are still in denial, but many are in the second stage—anger” (1).
According to Lee and Cosgrove, clarifying the underlying goal is the first step toward getting physician buy-in. In this case, they suggest that the goal should be focused on shifting emphasis from short-term maximization of revenue to a long-term strategy of putting patients first and increasing value. “The focus must be squarely on the stakes for patients,” they write (1).
From there, they recommend taking lessons from economist and sociologist Max Weber, who described the following 4 motivations that drive social action: shared purpose, self-interest, respect, and tradition. They stress the need for financial or other rewards for achieving targets, leveraging peer pressure to encourage desired outcomes, and creating standards to align behaviors. They also highlight the importance of using data “to demonstrate how proposed changes can improve efficiency and patient outcomes” (1).
The challenges identified by Lee and Cosgrove are the same as those identified by the ACC last year and are why the College and its leaders undertook the Herculean task of charting a new strategic path to guide us for the next 5 years and beyond. We clarified our goal early on in the process—to re-envision specialty care in light of the changing healthcare landscape and position the ACC as the professional home for the entire cardiovascular care team.
We, too, recognized the need to focus on patient value and to transform cardiovascular care to align with the “triple aim” of better health, improved outcomes, and lower costs. We engaged leaders, staff, and members throughout the process in order to determine how best to do this, and we ultimately came up with a plan dedicated to ensuring long-term member value through purposeful education, advocacy, and use of data and information, as well as providing a renewed focus on care transformation and population health.
The early buy-in from all stakeholders has made implementation of the plan that much easier, particularly as we move from talking about high-level strategic priorities to creating guidelines and standards for programs, products, and other innovations that ensure adherence to these priorities. Not to mention that the College has a 65-year history of leading the way in innovation across the spectrums of education, advocacy, science, data collection, and quality improvement. Leveraging this rich history and tradition, while looking to the future, has also been crucial to our efforts.
At the end of the day, Lee and Cosgrove say it best when they note: “The organizations that can help physicians live up to their aspirations as caregivers—to understand that giving up their autonomy is not actually surrender but a noble act of humility in the interest of their patients—will be the ones that improve efficiency, deliver the best outcomes, increase their market share, and retain and recruit the best people” (1).
This is our calling! As we work toward our mission of transforming cardiovascular care and improving heart health, we must remind ourselves that we are participating in something larger than ourselves. We are a team. We are part of a groundswell. We are part of a tide change. A shared purpose, whether as an organization, as a profession, or as part of the larger healthcare community, makes all the difference.
- American College of Cardiology Foundation
- ↵Lee T, Cosgrove T. Engaging doctors in the health care revolution. Harvard Business Review June 2014:R1406H.