James Merlino, MD, president and CMO of Press Ganey's strategic consulting division, wants to convince physicians around the country that hospital medicine is good healthcare as a whole.
“[Hospitalists] are the holistic scorekeepers for a variety of medical conditions that a lot of physicians don’t understand and don’t treat very well,” says Dr. Merlino, whose company supports healthcare providers in improving the patient experience. “We know that when their model is allowed to foster, quality improves [and] safety improves. It’s a model that needs to be embraced so we can deliver better care for patients.”
Dr. Merlino recently talked with The Hospitalist:
Question: You say you’ve seen some specialists and primary care physicians disrespect hospitalists. Why do you believe that occurs?
Answer: It’s a relatively new model, and physicians who have patients in the hospital, nonhospitalists, don’t like to give up the autonomy and the control they feel they have or the responsibility they have to care for patients. The hospitalist model challenges that.
Q: How does healthcare develop a culture that prizes hospitalists and encourages teamwork?
A: Number one, people have to call it out and talk about it. What surprised me in one hospital I visited was [that] the hospitalists did not elevate the issue to leadership. The second thing that relates to changing physician culture is accountability of leadership. When medical staff leaders find out about this type of behavior, it must be addressed.
Q: Why does the challenge persist?
A: It’s leaders stepping up and holding people accountable for their actions. Leaders sometimes have a tendency to ignore behavior problems. When issues like lack of professionalism are identified, then medical leadership really needs to step in and deal with the individuals who are creating the problem. That is a gap in healthcare.
Q: What stops leaders from being accountable?
A: The problem is that physician leaders and other leaders tend to shy away from controversial problems. Pushing into a medical staff issue like this is complicated and difficult. Physicians are the engines of your organization. Leaders are working very hard to keep the medical staff in a steady state … and often there’s a reluctance to push into behavioral problems. TH