Changes in Primary Care1

This blog was written as a collaboration between Maureen Metcalf and Jim Svagerko. It is a companion to the VoiceAmerica interview featuring Bill Wulf, MD and Jim Svagerko MA, PCC, talking about the leading work Central Ohio Primary Care with 300 physicians is doing and preparing for health care reform and new innovations in medical care over the next five years, and how it became a leader in their field and what they are doing to shape how the field of medicine and how it is practiced.

According to the Community Action Network, “A healthy community reflects a sense of mental and physical wellbeing and is the foundation for achieving all other goals. Good health is often taken for granted but is essential for a productive society. For example, every community needs a healthy workforce upon which to build its economy and healthier students are more equipped to learn and be successful academically.”

While the business of healthcare is run by physicians and administrators, health impacts every one of us. It is our responsibility to own our individual health because it effects our ability to enjoy life. Many of the challenges we face are a direct result multiple factors within the economy, and some health issues are a consequence of socio-economic disparity. Insurance plays a role when sometimes it is difficult to get access to the highest quality healthcare with the limitations on coverage. Additionally, factors in families and schools can play a role when adverse childhood events leave a lifelong impact on overall health.

Injurious childhood events often contribute to mental health and drug and alcohol issues later in life. Often, the cycle continues. Many of these factors are interrelated and solving them requires cross-sector focus on community health. Communities like Franklin County in Columbus, Ohio, have strong collaborative processes to address these complex issues.
While each of us plays a role in our own care, the linchpin of health care delivery has been determined to be the primary care physician. Dr. Wulf is the CEO of Central Ohio Primary Care (COPC), a group of 300 doctors at 50 offices in four counties. His clinical interests are preventive care, population management, and maintaining a continuum of care for COPC patients. As the CEO of an organization that is nationally known for its exceptional care and innovative business model, he continues to look at what COPC will do next to meet patient needs in the context of a dynamic health care environment. Here are a few of the changes COPC is talking about:
1. Move from pay for service to pay for outcomes: COPC is beginning to be paid for creating value for patients as they move from strictly fee-for-service payments. This shift completely changes how medicine is delivered and how doctors and all professionals associated with care delivery focus their efforts. COPC has taken a comprehensive approach to change that considers the overall system and how practices operate, the culture that encourages procedures as the foundation to manage risk, and physician scheduling and daily activities.
2. Move to a culture of vibrancy and collaboration: Significant change is enabled by a culture of mutual respect and collaboration where all team members are encouraged to voice opinions.
3. Leadership development: COPC has invested in physician leadership development through a variety of methods. Metcalf & Associate’s Maureen Metcalf and Jim Svagerko were engaged to support COPC, and assist them in their development. They guided the leadership team through their own personal development as well as a deep dive into the workings of COPC.  Maureen and Jim will continue their work with COPC this summer and fall. In addition, COPC sends their physician leaders for education through a local professional association and their leadership team is using the Innovative Leadership Workbook for Physician Leaders, supported by Metcalf & Associates, as a team activity along with peer coaching to support growth and development, as well as promote a culture of growth and mutual support during its transition.

One of the key trends we see in health care is a shift in focus from the “all-knowing” physician to patient owning health outcomes. We are seeing a dramatic increase in “wearables”, everything to medical devices like an insulin pump to the standard Fitbit® and calorie counting apps. Many of us are using these devices to manage our own behaviors. Primary care physicians and other healthcare professional are also using these apps and the data they provide to manage the chronically ill.

It is crucial that leaders in health care arm themselves with resources to assist them as they move through these undefined areas. It will be necessary for leaders to first gain an understanding of their leadership style and abilities before they can hope to lead others. One way is through careful discernment with an executive coach/advisor to explore and present opportunities for the leader to move into a space that will allow them to create a climate and atmosphere that will serve future health care needs.

SO….what can you do about becoming more effective? To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. Metcalf & Associates also offer several workshops to help you build these skills.

About the Authors:
Maureen Metcalf, founder and CEO of Metcalf & Associates, Inc., is a renowned executive advisor, author, speaker, and coach who brings thirty years of business experience to provide high-impact, practical solutions that support her clients’ leadership development and organizational transformations. She is recognized as an innovative, principled thought leader who combines intellectual rigor and discipline with an ability to translate theory into practice. Her operational skills are coupled with the strategic ability to analyze, develop, and implement successful strategies for profitability, growth, and sustainability.

In addition to working as an executive advisor, Maureen designs and teaches MBA classes in Leadership and Organizational Transformation. She is also the host of an international radio show focusing on innovative leadership, and the author of an award-winning book series on Innovative Leadership, including the Innovative Leaders Guide to Transforming Organizations, winner of a 2014 International Book Award.

Jim Svagerko
Jim Svagerko, MA PCC leads the Metcalf & Associates healthcare practice. He is a certified coach and has almost 30 years working within the Healthcare industry, first as a clinician and then as a teacher and coach. He has worked with many levels of healthcare associates including informal leaders, front line managers, physicians and executive leadership. In addition, Jim has coached in a variety of settings including legal, manufacturing and sales.

As a coach, Jim has operated in various ways to meet the needs of each leader. He utilizes many techniques such as one-on-one coaching, group coaching and mentoring. He believes that it is necessary for individuals to evaluate their own self first, examine their current behaviors and then discuss ways of integrating the knowledge they have received into their daily routines. Jim’s unique perspective of assimilating learning with self-development, allows the leader to fully integrate with the information and discover their personal meaning. He guides the person to a full awareness of self, prior to moving the individual to new thought.