Using Anesthesia Leadership to Raise the Bar


As healthcare reform drives clinical care and business together, there is an increasing need to integrate the two in a hospital setting. Premier’s Anesthesia Medical Directors (AMDs) understand hospital strategies and execution within each market and help hospitals maintain their competitive edge by providing physician input to C-Suite executives and OR staff. Premier Anesthesia AMD, Dr. Anthony Dominic, explains, “Due to MACRA, by 2017 the majority of our income will be based on quality outcomes. Because of this, you have to understand business as it relates to healthcare to be a physician leader. Getting paid is now tied to understanding business concepts and customer service rates.” Traditionally there is an adversarial relationship between administration and physicians, but Premier Anesthesia’s AMDs are able to help one understand the constraints of the other. Having eyes on both the OR and the budget, with expert knowledge of both, is a win for patients, physicians, and the hospital. Dr. Dominic says, “Our directors are well positioned to be able to work with the hospital’s administrative team. We have to maintain our competitive edge, but we have to help the hospital maintain its competitive edge as well. Good care matters, but the costs are real and need to be managed.”

In 2013, Premier Anesthesia saw a need to formally educate its executive medical staff in business and management in order to compete in today’s healthcare market and to provide better care for its staff and patients. Premier began a program in conjunction with UAB to offer AMDs the opportunity to earn a Certificate in Healthcare Administration. Some of Premier’s physicians have even gone on to earn their master’s in Healthcare Administration. Premier also conducts extensive personality testing when hiring AMDs to ensure their leadership capabilities. In this way, Premier has elevated AMDs from staff positions to physician leaders with the capability of creating a contemporary anesthesia department.

Initially, as an AMD evaluates a hospital, he takes stock of the OR and the Surgical Services Department and might see a need to restructure a dysfunctional system. Dr. Dominic says, “I embrace transformational change. I like to take a puzzle and figure it out.” When asked why he is successful in his position, he says, “My team is successful. I hire the right people and develop a team complementary to each other.” Premier’s AMDs are careful to build a team that puts the right people in place to work together and to provide excellent care while staying within the hospital’s budget. Premier AMDs are careful to communicate expectations clearly so other hospital staff understand this role. The staff know what to expect and what to ask for. Because AMDs are well versed in business, they are able to help set a vision and provide leadership for the OR staff and other hospital staff on everything from patient care to value-based purchasing. They understand the mindset of the CEO/CFO, but also the clinical demands of other staff. Clear communication allows Premier’s physician leaders to bridge the gaps between the medical staff and administration. This collaborative approach leads to increased problem solving and staying ahead of the curve as far as competitors are concerned. And Premier is not just maintaining its competitive position. Compared to local anesthesia companies, Premier is far more prepared.

While Premier AMDs provide leadership among all hospital staff, they also advocate for the patients. Dr. Dominic is passionate about customer service, which he believes is rooted in good character. He says, “I identify people with similar values, morals, and work ethic. If you don’t have these things in common, it doesn’t mean you’re not valuable, it just means you won’t fit on my team. There are no alpha males on the team. Be polite and well-mannered.” This results in excellent care for patients, as well as helping the hospital thrive financially. He reiterates, “Customer service is so important. There is a true cost to your behavior.” As reimbursement is coupled with quality outcomes and customer service, there is an increasing need for Premier’s type of leadership. Possessing a unique skill set, Premier’s AMDs foster communication among all hospital staff to create a great patient experience and to help hospitals maximize resources.

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