We have long understood that product standardization, within an integrated delivery network, is difficult to accomplish due to the extent to which physicians have strong preferences for products. Consequently, among the additional roles that physicians take on is to serve as “surrogate buyers” within the hospital. This ensures that their preferences are sustained. For physicians and other clinicians, it is even more complex when they are challenged in an environment where the volume of medical knowledge doubles every 24 months.
Supply chain executives, as well, find it particularly challenging to engage in sourcing programs where in exchange for preferred pricing they make guarantees to suppliers that favorable pricing, based on consolidation of spend, will actually occur. Much of this change is due to product proliferation, with over 4,000 new 510Ks approved annually in the US. As a result, no one individual (neither clinician nor administrator) can be sufficiently knowledgeable to fully consider the changing world of options. Best practices today may not be the best practices tomorrow! Accordingly, it is an environment where physician leaders must build an environment where clinical colleagues understand that supply chain is their link to clinical excellence.
Physician leaders need a strong understanding of the purchasing dynamics in their own organizations. They must recognize that they act as representatives of the medical staff to supply chain management – but not as “mere delegates” who assure that all decisions meet the wishes of all colleagues. Thus, to be successful representatives, they must be trusted by their physician colleagues that they will not only act to meet colleague consensus (and consequently patient), but also act in patient best interest and in consideration of challenges to organizational sustainability.
Physician leaders have become orchestrators of a complex process. Unfortunately, there is little in clinical education that provides physicians with the skill set for such orchestration. Successful representation, to meet the needs of both physicians and supply chain goals requires that physician executives
- Meet early and often with their clinical colleagues who utilize items characterized by preference.
- Communicate that their role is to assemble data for colleagues to sustain or reshape preference based on careful reflection
- Recognizing that they and their colleagues are “evidence driven,” engage with supply chain staff to gather credible data on product utilization and the ways products contribute to clinical outcomes and cost within an episode of care
- Work with clinical colleagues to consider and craft exception policies that demonstrate that they understand that many product decisions are unlikely to meet the contingent needs of all physicians nor requirements for patients
- Know that the autonomy at the patient level is important – but that in an era of “big data” – autonomy must be grounded in meeting “evolving” and revised standards of care.
At HSCX we have carefully studied these issues and challenges facing physician leaders. We understand many of the dynamics and, more importantly, the solutions and tools for orchestrating this complex process. Our ideas and solutions have spurred healthcare organizations to significantly improve their ability to link clinical practices to the supply chain.