Physician executive
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Physician executive · Jun 1995
Comparative StudyWhen push comes to shove: implementing VBAC practice guidelines.
The dramatic increase in U. S. cesarean sections over the past two decades has been significantly driven by repeat C-sections. In response to this trend, clinical guidelines recommending vaginal birth after cesarean-section (VBAC) have been promulgated by national organizations. ⋯ Those surveyed generally were medical directors in HMOs, hospitals, and other practice settings. The findings indicate that the health care organizations represented by these physician executives have not consistently implemented VBAC guideline and that they are reluctant to hold physicians, their patients, or hospitals accountable for the financial, utilization, and quality impact of the elective decision ot to pursue appropriate VBACs. We conclude that, even when widely accepted, clinical practice guidelines may be ineffective in reducing the costs or improving the quality of medical care.
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Consultants can and do play many different roles for the client that hires them. In many cases, it is not as simple as it may appear in terms of laying out the problem and then letting the consultant you have contracted with either solve it for you or present you with options from which to pick the best solution. The retaining of outside expertise is usually done for one or more of the following reasons (by no means inclusive): Lack of "in-house" manpower or time to deliver a product. ⋯ Getting someone outside your organization to deliver unpopular or bad news. Genuine interest in the independent findings and recommendations of the consultant. Whatever the motivation for seeking the advise of outside counsel, be sure you are prepared for the answer they may give to the question you have asked.
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Consulting services would not be the multimillion industry they are if the results were not of value to those using them. Obviously, consulting pays off in some large percentage of cases. But it does not happen automatically, and the consultant used is less important in the process than the advance work that is done by the client in establishing the conditions under which the consultation will take place. In the following example, preplanning led to a result that was immensely satisfying to all involved.
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To have a successful career in management, you have to pay more attention to refining your communication skills than you ever thought was necessary. In a survey of 100 physician executives, 94 percent felt training was needed in communication skills if you are thinking about becoming a physician executive. When recruiters talk to us about the basic requirements for physician executives, one of the things they say the person needs to have is excellent communication skills. ⋯ We have to take in information about that world and make decisions all day long. We don't all do this in the same way. In this article, I am going to discuss four ways to process information.