Thinking back to my beginnings in supply chain and value analysis in 1999 at Orlando Health, my first project with physicians and implants centered on cardiac rhythm management. In those days, we in “materials management” were not allowed to touch anything that was considered “physician preference” from a surgical standpoint. The facility did not have ready access to implant costs or competitive benchmarks, so this assignment was uncharted territory. I vigorously delved into the pricing by each vendor, manually reviewing the implant logs to determine which implants were being used by which physicians. The results were compelling: pricing was all over the map!
The director of materials management and I then secured a meeting with a large cardiology practice using the facility for implant procedures. We were excited and prepared to share our findings with the cardiologists. “This is great. We have pricing and who used what device and vendor.”
We pulled together our presentation, clearly demonstrating the wide range of prices the hospital was being charged. Their response? No one cared. We did not have a physician champion. We left the room in defeat.
It has been 20+ years since that first foray into value analysis. Sure, we have more data on patient outcomes, cost and even the benefit of peer benchmarking but to move toward savings goals through less variation in devices and related supplies, a physician champion is still needed to lead the charge. And the burning question remains: “How do you engage physicians?”
Identifying a physician champion
As consulting director at Vizient, my focus is on developing and implementing custom-designed clinical-supply integration (CSI) and governance models, which always include a strong value analysis program. Recently, a member requested we design and implement a system-wide, physician-led clinical quality value analysis (CQVA) program to replace a make-shift surgery value analysis committee that had fallen apart due to the lack of an engaged physician leading the charge.
To meet the member’s request, we focused on surgery as our first CQVA committee. We needed a physician chair. To ensure we obtained interest from physicians who wanted to be engaged in the work and had a desire to lead the effort, I sought out the highest level surgical department chief who was also a supporter of value analysis to assist in the appointment of a surgical CQVA physician chair. With his help, we started to spread the word about the opportunity, including that the chair would have decision-making power and input on what new products were approved. The chair would also assign physician subject matter experts to savings initiatives based on data that interested the physicians themselves. This position would be overseen by a governance structure for support and decision-making.
As word started to spread among the physician population there were questions: How much time would this position require? What were the roles and responsibilities? Which physicians were interested? Who was making the decision on the chair position? Who will be on the surgical CQVA committee? What type of data is available?
After a few weeks of building interest, we had five surgeons who wanted the position of chair.
Selecting a physician champion
An interview panel of key administrative leaders, surgeons, OR directors from different facilities and those in the CQVA department was assembled to facilitate the selection process. I teed up a list of supply chain and CQVA questions and scenarios for the candidates to address. Each panel member and candidate received the questions before the interview sessions. Each interview was 50 minutes in length and held virtually due to COVID. The physician candidates did not know who the other applicants were.
The results were nothing short of amazing. One physician wrote all his answers to the questions and turned them in ahead of time. Two physicians were dressed in their lab coats and were sitting in their offices, medical books displayed in the background. One had to interview in between surgical cases dressed in his scrubs. We had created an atmosphere of friendly competition and inclusion! The physicians were excited to participate, and someone was going to be selected.
All candidates were asked if they were not chosen for the position of chair, would they be willing to participate on the surgical CQVA committee. The answer was unanimous: YES! We continued to build on this momentum to help us fill the actual membership of the committee, as we wanted to be heavily populated with surgeons. The member was primed to continue their journey toward CSI.
Three ways to generate physician interest
Based upon my experience, here are three ways to help generate physician interest and excitement for leadership in supply chain initiatives:
- Building excitement:
- Set the atmosphere
- “We are accepting applications for the chair position”
- “We will be holding interviews for the chair position”
- Prepare interview questions, including situational scenarios
- Put a diverse interview panel together
- Decide how the interview will be scored
- Ask those not chosen as chair to participate as committee members
- Set the atmosphere
- Finding a physician chair:
- Identify high-level, influential, administrative leader, surgeon, OR business manager that supports CSI and is well known and respected among physicians
- Look to physicians who have experience working on savings or utilization initiatives or experience in value analysis
- Consider physicians looking to further their career in administration or have an interest in business
- Identify physicians who are published, involved in clinical trials, present at speaking engagements
- Pointing out the benefits of the role:
- Lead decision-making
- Assist in creating a membership committee
- Improve the process for new technology adoption (remove barriers)
- Reduce the need and improve the process for urgent (last minute) requests
- Increased accessibility to data
- Weigh in on the selection of savings initiatives and choose the subject matter expert physicians who will lead initiatives
- Assist with re-investment of savings
About the author: As consulting director, Donna Colby leads and delivers custom designed clinical supply integration and governance models.With over 40 years of health care experience, Donna has spent the past 20+ years working directly within supply chain for organizations such as Orlando Health, AdventHealth and Stanford Health Care. Her consulting experience includes supply chain due diligence work for Big 4 companies such as PwC, leading total joint and spine savings initiatives for consulting groups such as Owens & Minor, Huron, and FTI. Donna holds a Bachelor of Science degree in nursing, is a Certified Resource and Materials Professional (CMRP) and as a licensed health care risk manager, owned and operated her own health care risk management consulting business for 10 years in Orlando, Florida.