Tony Mira, Chairman and Chief Executive Officer of MiraMed
Anesthesia Roads Less Traveled: Paths to Executive Leadership Positions
Among the offerings at ANESTHESIOLOGY® 2018 was a panel discussion by three anesthesiologists who have made the successful transition to executive leadership roles in healthcare administration, industry and public policy. We highlight selected comments from the panelists and ASA resources for members interested in pursuing various kinds of leadership opportunities.
One of the most thought-provoking sessions at ANESTHESIOLOGY® 2018 in San Francisco was the panel discussion on anesthesiologists as leaders in healthcare administration, industry and public policy. This eAlert provides insights from participants on why they made the transition and what that journey entailed.
"I'm biased, but anesthesiologists are natural leaders when it comes to being physician executives," said moderator Mohammed M. Minhaj, MD, MBA, of the University of Chicago, who organized the panel with ASA CEO Paul Pomerantz, MBA. "They understand the perioperative space better than anyone else, they work with all sorts of personalities—which gives them an advantage in terms of dealing with them—and often, their interests are aligned with the healthcare system, which allows them to be sort of neutral when it comes to settling problems with different kinds of providers."
In addition to having many of the skills to become physician executives, anesthesiologists also have the desire. Twelve percent of participants in the ASA's most recent biannual survey indicated interest in moving into an executive position within the next five years, Mr. Pomerantz reported. Among mid-career members (age 41-55), that number rose to 18 percent. "It's a viable career interest, and a specific area of interest," he observed. "Anesthesiologists are in a unique position because you work with multiple specialties, you deal with conflict, you deal with complex systems, and probably more than anything else, you deal with the focal point of the hospital's business—the operating room and the procedural areas, where the revenue is generated."
The ANESTHESIOLOGY 2018 panel consisted of three anesthesiologists whose career paths have involved taking on various non-clinical leadership roles, within and outside of medicine. Selected comments regarding their career paths follow.
William (Pepper) Denman, MD, principal, Denman Associates; pediatric anesthesiologist, Massachusetts General Hospital; former chief medical officer, Premaitha Health, GE Healthcare and Covidien. "It [the transition to a non-clinical executive role] had nothing to do with not wanting to be a doctor. It had nothing to do with not wanting to drive medicine. It had to do with what I saw as a real challenge. People would say to me, 'Why did you quit practicing medicine?' I still have the good fortune to see patients at MGH once a week. But I began to see my role as trying to practice medicine on a larger scale. I wanted to see good practice and good ideas and good solutions to unmet needs become operationalized. That requires you to try to push behavior change and push things into the market. One of the roles that is so important for [clinicians] is to help our industry colleagues understand how to be patient-centered and provider-focused as they begin to develop products and devices and opportunities to improve healthcare."
Sam L. Page, MD, chair, St. Louis County Council and former member, Missouri House of Representatives, 2003-2009. "Government has an enormous impact on your practice and an enormous impact on your business. The regulatory environment will sometimes decide if you survive or don't survive. Like it or not, government is here to stay, and you need to understand how it works and have some point of contact. I realized you can have an impact."
"A lot of people ask how I balance family, work and serving in public office. But state legislature is a part-time commitment. If you can take a little bit of time off from your practice and you've got a group that's flexible enough to let you do it, this isn't rocket science. This is not medical school. It's not residency. This is about understanding an issue, learning who to trust, reading the bills and making a thoughtful vote. If you can get past the negatives [of running for office], and you've got a thick enough skin to let it all roll off of you, you get to change the decisions governments make, you get to change the environment that you're practicing in and you get to advocate for your patients outside of the operating room. It's your duty to speak up for your patients, not just in the operating room, but also outside, interacting with hospitals, health plans, third-party payers and elected officials."
Mary Dale Peterson, MD, MHSCA, FACHE, chief operating officer, Driscoll Children's Hospital; former CEO, Driscoll Children's Health Plan; first vice president, ASA. As an anesthesiologist in a short-staffed department at Driscoll, "I realized that I needed to understand the finances of the department and the contracts we had in order to get the number of people we needed because we were working really hard. That's when I took over the office administration and renegotiated all of the contracts. When the resource-based relative value scale (RBRVS) rules came out, Medicaid payments were being cut 25 percent. I had to negotiate with the hospital administration for subsidies to keep our anesthesia department together. That was my journey into understanding that finance and negotiation skills are really important.
"People ask me 'Wouldn't that be boring, getting into administration?' In a children's hospital, you see a lot of sad things, but what was saddest was seeing children with a lot of preventable conditions. The reason I went into medicine to begin with was to advocate for our patients. When you see things that are wrong you keep working on fixing them. But none of these things were planned in my life. Sometimes the best things are unplanned."
The current environment is favorable for anesthesiologists interested in making the transition to executive positions, including positions as healthcare administrators, Mr. Pomerantz said. "Now, most leading healthcare systems are looking for and demanding clinically oriented leaders to lead the system." The ASA has responded by making leadership development a pillar of its strategic plan. As part of that plan, ASA has partnered with the American College of Healthcare Executives and the Northwestern University Kellogg School of Management to develop a range of leadership development opportunities for members. "There are already a lot of anesthesiologists in leadership roles," Mr. Pomerantz said. The goal of the current initiatives is to further this leadership development so that more members can become influential in decision making.
With best wishes,
President and CEO