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On the Perils of Dr. No and Dr. Right: How to Select Physician Leaders

August 25, 2011
Dr. No is legendary in the physician community surrounding General Specialty Hospital.  Solid diagnoses and referrals come to him only to be unraveled by obscure tests and unusual treatment methods.  Dr. No doesn’t necessarily hold a grudge against his medical colleagues, but he always seems to think there is more to every case.  He likes to delve deeply into each case to find out what was missed and how he can save the day.  Scorn and ridicule from his colleagues is private, but rampant.  Recently, the physician leadership position at GSH was vacated and Dr. No has thrown his hat into the ring.

The Medical Executive Committee and Administration form a subcommittee to search for a replacement for the physician leadership role.  After engaging a search firm and conducting a national recruitment campaign, the subcommittee identifies a candidate, Dr. Right. He matches the qualifications and qualities deemed important for taking GSH to the next level.  Dr. Right possesses a strong background in leading physicians and producing high quality results for hospitals.  So, he is fully vetted and a detailed description of his assets is proffered to the Medical Staff to help with their decision.

Finally, the Medical Executive Committee presents Dr. Right and Dr. No to the Medical Staff for their decision.  And now, dear readers, you know what happens.  Physicians at GSH overwhelmingly vote to appoint Dr. No as their next physician leader.

What went wrong?  Was this very important decision as simple as “the devil you know is better than the devil you don’t?”  Is the rapport between Administration and the Medical Staff so poor that physicians will choose their own over an outsider?

The reality in this true story is that the selection subcommittee failed to take the proper steps to provide stakeholders with what they needed to make the right call.  Physician executives possess a unique and specialized combination of competencies that allow them to forge the gap between hospital administrators and physicians.  The subcommittee formed their own mental model and matched a candidate to that, thereby making two critical errors. First, they failed to explicate their competency model to the Medical Staff – to say, “These are the things that are valuable in this role and this is how the candidate fares on those things.”  And second, they only vetted one candidate.

The application of competency modeling and selection for physician executives is sorely under-utilized in healthcare today.  But if it had been employed at General Specialty, the development of that model and a scientific approach to portraying strengths and liabilities for both candidates would have provided the Medical Staff with an evidence-based solution to the decision they had to make.

Dr. No runs General Specialty with the same irritating and disgruntling approach to physician leadership that he uses in patient management.  Administration is unhappy.  Physicians are unhappy.  And Dr. Right is making some other hospital very successful.

Drew Brock, Ph.D.