By Nishi Saini
What makes a good doctor? How might he or she be assessed? Could it be the level of confidence inspired in a patient? Perhaps, it is the length of their career. Truth be told, measuring productivity in healthcare is a deeply subjective affair and calls for introspection. And so is the quality of leadership.
In March 2017, Dr. Ronald DePinho resigned as CEO of MD Anderson Cancer Center in Houston. In his resignation, he said that the center “needs a new president who will inspire greater unity and a sharp focus on navigating the tectonic changes in healthcare delivery and economics.” Citing this example, an article titled Most Doctors Have Little or No Management Training and That’s a Problem, in December 2017 edition of Harvard Business Review wrote, “His lack of strategic perspective and inability to balance the institution’s financial, business, and clinical demands revealed he wasn’t right for the role.” It said many physician leaders who are promoted to lead an entire enterprise or a segment lack the necessary experience for the job. “They aren’t skilled in managing and blending functional and business strategies, portfolio assessment, factoring in short- and long-term tradeoffs, and taking a longer-term strategic approach to decisions. These shortfalls can render such leaders ineffective,” it further said.
Healthcare services companies continuously grapple with this challenge. Knowing well that a doctor as leader is the best proposition, they still find it difficult to create a pipeline of hierarchy or leaders, diligently groomed to take on the mantle for higher responsibilities. Therefore it is vital that along with creating sound HR practices for evaluation, organizations must also work on creating an enabling framework which proactively identifies and nurtures doctors as leaders. So the practice of evaluation and instilling leadership abilities goes hand in hand.
Let us take a look at some of the traditional scenarios of clinical performance measurement. For decades, healthcare professionals in India operated without any clearly defined human resource policies or systems. In the past, performance in this sector was found to be directly or indirectly linked to financial incentives, leading to malpractices such as over-treatment and relatively poor ethical standards. Call it a cultural issue, HR glitch, lack of empathy or appreciation for global best practices, most of the healthcare agencies stayed away from deploying quality tools for clinical performance assessment.
It is incumbent that healthcare organizations ensure deployment of finest clinical care standards and protocols for patients satisfaction. While working on it, doctors should be roped in by the HR team. This helps in indirect seeding of a new idea and also ensures that doctors become part of the process of creating a new protocols. One can’t rule out some reluctance and resistance, but isn’t HR is all about negotiating the tricky! Along with this, it is also critical to lay down a robust model of growth for doctors. How is her career progression path being defined; what are the parameters for the evaluation; is there a leadership pipeline available for her; are there models that she could look up to even as she aspires to take on a bigger responsibility few years down her career – are some of the questions that should be factored in by the HR professionals into the progression protocol.
One of the surest ways to evaluate performance is through assessment of the quality of treatment. While people may argue as to the method of this assessment, there are ways and means of achieving the same. For instance, in the dental care section, quality can be measured by the level of adherence to hygiene protocols, sterilization procedures, patient handling etc. Each case work can undergo a review by a group of senior specialists. Individual scores can be assigned and a summary of performance can be made available, as in our case, at the end of the month. It is also recommended that organizations should design regular capacity building exercises besides skill upgradation and scientific sessions, which can be an occasion for doctors to delve on ongoing trends and best practices.
After all, people value careers, not jobs. HR managers should always be mindful of this fact and chalk out career paths for doctors. Access to training and opportunity to interact with senior specialists should be regular feature of a sound HR policy. It is also recommended that at the time of joining doctors be informed about the opportunities available to them in terms of vertical and lateral movements.
We are also living in dynamic times where it may be advisable value potential and talent more than the premium attached to experience and send out the message that the ever-elusive ladder of progression is truly a result of talent and not only of experience. We subscribe to this view and religiously follow it. Clove is proud of the fact that 70% of its clinical and middle management positions has risen from within their ranks. Clearly, our efforts have paid off.
(Nishi Saini is Vice President, HR & Talent Development, Clove Dental)