by Guy M. Kezirian, MD, MBA, FACS
CEOs lead, they do not manage. Leadership is about strategy, values and purpose. Administrators and managers need strong leadership to perform effectively. In the medical setting the leadership role falls to the Physician CEO.
Why? It goes back to the purpose of the firm. In classic (American) business training, the purpose of the firm is to “maximize shareholder equity.” In other words, make as big a profit as possible for those who own the business. That purpose does not apply to medical practices. In fact, I don’t know a single physician whose sole motivation is to make a buck. Most physicians first work to take care of patients and under a standard of excellence, and expect the money to follow. As such, the purpose of the firm is dual—the first to provide great patient care while practicing our hard-earned skills, and secondarily to make money.
Just as I have never known a physician who held profit as their sole motivator, I have known very few businessmen who put patient care above profit. Therefore, it is a fundamental misalignment of values to have a businessman-CEO run a medical practice. Being a CEO is all about conveying values, and that has to start with the “Physician CEO.”
Medical practices are value driven. While some practices call their administrator a “CEO”, the physician is still the CEO. If you doubt this, then ask yourself “If my CEO said we were going to re-use supplies between cases, would I do it?” Of course not! That would be profit-driven move that would put patients at risk. But the fact that you are in a position to say no proves that the so-called “CEO” is not really a CEO at all.
Nobody can say “no” to the CEO. Because you can, he is not really a CEO. The only power a firm (shareholders/board) has over a CEO is to hire and fire him/her. Otherwise, the CEO is the boss.
The prior generation of physicians was gulled by prospects of an easy life and expanded patient rolls when they agreed to the government takeover of medicine with Medicare in the 1960s. The current generation of physicians is paying the price through eroding freedom and opportunity.
Businessmen and bureaucrats to a terrible job of running medicine. We have empirical evidence to prove it. It is time for physicians to regain control. We must step up and grab the reins. This is our profession and it must be run according to our values.
The only way that can happen is if physicians are in control, and that must start with our own practices. Be a Physician CEO.