Page 6 - SFHN22 Feb 22finalUF.qxp_SFHN 0608 Friday 5.0

Do Physician-led Hospitals

Perform Better?

According to the global CEOs report better clini-
executive search firm, cal and financial perform-
WittKieffer, the demand for ance than hospitals with
physicians to lead hospitals nonphysician CEOs (at
and health systems has been the 95% confidence
increasing over the past three level). The data did
years. What is driving this demonstrate that physi-
demand? Some say that it is cians were more likely to
the industry’s move to value- be the CEOs of teaching
based care, which focuses on hospitals, nonprofit hos-
quality care versus volume- pitals, and larger hospi-
based care. tals. Physicians were also
As a practicing pediatric BY LEON E. MOORES, more likely to lead hospi-
neurosurgeon, I have spent MD, DSC tals owned by a system.
much of my career serving in This was a very focused
combined clinical and lead- review and therefore sub-
ership roles in various healthcare organ- ject to a number of limitations. This
izations. In questioning whether care study does not imply causality due to the
quality differs in healthcare organiza- retrospective nature of a cross-sectional
tions led by physicians I’ve found little data analysis. Second, this study used a
evidence-based research measuring hos- single year of data, which for many rea-
pital performance relative to physician sons may not be representative of longer-
CEOs versus non-physician CEOs. As term performance. CEO tenure is impor-
such, I chose this research topic as I pur- tant, as there is often a lag between the
sued my Executive Doctor of Science in CEO’s appointment and CEO-driven
Healthcare Leadership degree at the changes in organizational outcomes.
University of Alabama at Birmingham. In This study included CEOs with more
2021, my dissertation “Reported Clinical than one year in the position, resulting
and Financial Performance of Hospitals in over 25% of CEOs with less than two
with Physician CEOs Compared to those years’ tenure. Finally, the study did not
with Nonphysician CEOs” was pub- examine additional hospital characteris-
lished in the American College of tics and/or CEO leadership traits which
Healthcare Executives’ (ACHE) Journal may be better predictors of clinical or
of Healthcare Management’s financial performance.
November/December 2021 issue. As previously mentioned, there has
Since existing leadership theory and been little empirical work done compar-
some research suggest a relationship ing the performance of hospitals with
between technical expertise and success physician CEOs versus non-physician
in leading highly technical organiza- CEOs. More work in this area could be
tions, I hypothesized that hospitals led useful to inform hospital CEO recruit-
by physician CEOs would report higher ment and selection processes. Future
levels of clinical and financial perform- studies may consider independent vari-
ance compared to hospitals with non- ables of hospital size, teaching status,
physician CEOs. The single-year, cross- not-for-profit ownership, or clinical lead-
sectional analysis of U.S. acute care hos- ers in other professions such as nurses,
pitals showed no differences in reported therapists, and technicians. This work
performance. adds to that discussion, and hopefully
The sample population included 190 will be useful.
hospitals, half (95) with non-physician In conclusion, while it may be appeal-
CEOs and half with physician CEOs, ing – and would certainly be efficient –
randomly selected from over 1,900 AHA to be able to ascribe outsized impact of a
database U.S. medical surgical hospitals single, measurable leader characteristic
with more than forty beds. All CEOs had (such as being a physician), this study’s
at least one year of tenure. Three stan- data do not strongly support that. It
dard reported quality measures were turns out that, like leadership itself, lead-
chosen: actual/ predicted central line- ership selection is a complicated busi-
associated bloodstream infection (CLAB- ness and there are likely no simple solu-
SI) rates, acute myocardial infarction tions to help organizations choose the
(AMI) 30-day risk-adjusted mortality leader best suited to maximizing hospital
rates, and pneumonia 30-day risk- performance.
adjusted excess readmission rates.
Financial performance was evaluated Dr. Leon E. Moores is Professor of Surgery
based on hospitals’ return on assets and and Pediatrics, Uniformed Services
operating margin. The study also con- University School of Medicine, and
trolled for 13 hospital characteristics and Professor of Medical Education,
market factor variables. University of Virginia
This analysis did not support the School of Medicine (Inova)
hypotheses that hospitals with physician

Subscribe to...

SOUTH FLORIDA HOSPITAL NEWS &
HEALTHCARE REPORT today!
Subscribe online at
www.southfloridahospitalnews.com
or call 561-368-6950

6 February 2022 southfloridahospitalnews.com South Florida Hospital News