Nonclinical competencies physicians need to survive

As increasing numbers of physicians are called into leadership positions, new skills are needed to meet the many nonclinical demands required to fill these positions.

During a session called “CV Summit 2015: Top 10 Lessons” delivered at the ACC meeting, C. Michael Valentine, MD, an interventional cardiologist in Lynchburg, VA, and Treasurer of the ACC, described four major areas of nonclinical competencies that, Valentine says, “physicians need to survive in the world today.”

The lessons were gleaned from the annual CV Summit developed to provide training in four key areas needed for healthcare leadership positions. These nonclinical competencies include areas of leadership, using data to improve quality, streamline management, and finance.

“These are the kinds of things that you don’t learn in medical school, residency, or fellowship triaging,” Valentine says. “More and more physicians across the country are being called into positions of leadership, including not only running their practices but running hospital service lines, and they are not trained in the critical skills needed for positions of leadership.”

The top 10 lessons summarized by Valentine were optimize electronic health records, primer on leadership (leadership 101: personal and group plans), team-based care model, leadership succession plan, provider satisfaction plan, coding consultant and champion, dyad leadership plan, group-volume to value transition, dashboards/report cards, and volume to value.

For example, he spoke on the transition in healthcare institutions from volume-based to value-based care and highlighted the steady shift toward risk-based payment with more mandatory, optional risk programs on the horizon and the need for physicians and institutions to know which current payment cuts they can control (e.g., readmission reductions and value-based purchasing).

 “We need to help physicians and practice and hospital managers learn these area skills and improve not only the quality of patient care, but the efficiencies in their systems,” Valentine says.

Commentary by Pamela S. Douglas, MD, Ursula Geller Professor of Research in Cardiovascular Disease, Duke University School of Medicine, Duke Clinical Research Institute, Durham, North Carolina:

As healthcare reform continues to change how we think about care delivery, it is increasingly important for physicians to be able to lead the transformation. Most learn ‘on the job’ but this haphazard approach can leave important holes in skills and knowledge critical to success in the new volume to value world. While these issues can never substitute for excellence in clinical care, even the Accreditation Council for Graduate Medical Education recognizes their importance. Two thirds of the six core competencies by which training programs and trainees are judged fall into these categories: Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice. (The remaining two competencies are Patient Care and Medical Knowledge.) The ACC views supporting its members in this area as mission critical, and has a strong track record of commitment to quality, data-driven care and the care team.