Dr. Michael Sherman Health Leader Forge Podcast
Oct. 15, 2017
This interview was with the CMO at Harvard Pilgrim Health Care, who went to U.Penn and is a board certified anesthesiologist. He never wanted to work for insurance agencies, but clearly, he is not an executive in one. It is always interesting to me to listen to physicians who have moved up the ladder to a senior exec. position. I enjoy seeing the physicians get more involved in administration, because I think it helps keep the patients' interests in mind.
Dr. Sherman has a wide knowledge reservoir in the sciences as well as anthropology. This is a huge part of getting into medical school, and being a physician. While physicians must be intelligent, they also need to be holistic in their thinking. This, I'm sure, helped him get to his current CMO position.
He began his medical career, as an anesthesiology resident. He explained that he enjoyed the diversity that you saw as an anesthesiologist. The beginning of this interview was interesting to me, because I thought his outlook on residency and being a doctor was interesting. He explains that while you are technically a legal doctor in residency, you really have to feel competent and confident to truly feel like a doctor. I think this is an important point, because doctors should never have too large an ego that they cannot step back for a second opinion, but also believe in themselves and their diagnosis.
After being an anesthesiologist, he went back to obtain to an MBA. He didn't want to go back to work in insure or healthcare administration, because he felt that these executives tend to hold back the practice of medicine. Today, he does not feel the same way. He sees these executives now as moving forward healthcare and administering the best possible care. Many physicians have this mindset that administration is against them, but they are there to implement the best possible service lives, and help add processes to provide excellent healthcare.
Interestingly, he saw many hospital managements that were not performing well. He thought that he could help change this. I think this is extremely important, because the doctors need to be involved in administration to have this input. Poor management leads to more expensive, less effective care.
For me, planning to go to medical school, but minoring in HMP, hearing this interview was really interesting. I am interested in the administration and insurance aspect of healthcare. While I cannot see myself giving up a clinical job for an administration job, but after hearing this interview, it shows me that you never know what you'll end up doing. He talks about the importance of having a reputation as a physician and how he chose to leave the clinical work, not because he couldn't handle it, which other colleagues assumed. There is truly a lot of egos and opinions in the healthcare field that one needs to be prepared for going into these types of careers.
He also touches on "fee for service," payment plan, and how it is not the most effective option. These physicians see it is as losing money if they lower ER visits, or re-admissions to the hospital. Incentives and cost sharing ideas are extremely important. Care is expensive, and there is a push for value-based care. This will increase incentives for providing excellent care, because there is a return on investment there. He describes it as getting physicians to realize they'll get paid for the things they do well, rather than what they get paid for in general, like having a patient readmitted.
Physicians help patients, and that is what they are trained for. However, they are buried in debt, and have families like everyone else. The incentive currently is that providing more care will give them more income. Instead, paying physicians for value provides the patients with the best possible care, while the physician is getting a return. It is also about how physicians take risks and manage their patient's care. They can also take part in a shared-risk model. This gives physicians who have good outcomes get a share from the risk model.
He touches on oncology units. This is not the best way for value-based, because they do not have the best outcomes. This may not be due to their practices, but because of the disease prognosis. However, they sat down and discussed ways that they could be more effective, and how they could be compensated based on them adopting these practice (i.e. palliative care, home care, etc.).
I think this is the best way to compensate healthcare providers. For everyone, they are receiving the best outcome. The patients will know they are getting the highest quality health car, because their physicians are motivated by incentives to provide excellent care. To me, this system seems to be ideal moving forward.
This interview was with the CMO at Harvard Pilgrim Health Care, who went to U.Penn and is a board certified anesthesiologist. He never wanted to work for insurance agencies, but clearly, he is not an executive in one. It is always interesting to me to listen to physicians who have moved up the ladder to a senior exec. position. I enjoy seeing the physicians get more involved in administration, because I think it helps keep the patients' interests in mind.
Dr. Sherman has a wide knowledge reservoir in the sciences as well as anthropology. This is a huge part of getting into medical school, and being a physician. While physicians must be intelligent, they also need to be holistic in their thinking. This, I'm sure, helped him get to his current CMO position.
He began his medical career, as an anesthesiology resident. He explained that he enjoyed the diversity that you saw as an anesthesiologist. The beginning of this interview was interesting to me, because I thought his outlook on residency and being a doctor was interesting. He explains that while you are technically a legal doctor in residency, you really have to feel competent and confident to truly feel like a doctor. I think this is an important point, because doctors should never have too large an ego that they cannot step back for a second opinion, but also believe in themselves and their diagnosis.
After being an anesthesiologist, he went back to obtain to an MBA. He didn't want to go back to work in insure or healthcare administration, because he felt that these executives tend to hold back the practice of medicine. Today, he does not feel the same way. He sees these executives now as moving forward healthcare and administering the best possible care. Many physicians have this mindset that administration is against them, but they are there to implement the best possible service lives, and help add processes to provide excellent healthcare.
Interestingly, he saw many hospital managements that were not performing well. He thought that he could help change this. I think this is extremely important, because the doctors need to be involved in administration to have this input. Poor management leads to more expensive, less effective care.
For me, planning to go to medical school, but minoring in HMP, hearing this interview was really interesting. I am interested in the administration and insurance aspect of healthcare. While I cannot see myself giving up a clinical job for an administration job, but after hearing this interview, it shows me that you never know what you'll end up doing. He talks about the importance of having a reputation as a physician and how he chose to leave the clinical work, not because he couldn't handle it, which other colleagues assumed. There is truly a lot of egos and opinions in the healthcare field that one needs to be prepared for going into these types of careers.
He also touches on "fee for service," payment plan, and how it is not the most effective option. These physicians see it is as losing money if they lower ER visits, or re-admissions to the hospital. Incentives and cost sharing ideas are extremely important. Care is expensive, and there is a push for value-based care. This will increase incentives for providing excellent care, because there is a return on investment there. He describes it as getting physicians to realize they'll get paid for the things they do well, rather than what they get paid for in general, like having a patient readmitted.
Physicians help patients, and that is what they are trained for. However, they are buried in debt, and have families like everyone else. The incentive currently is that providing more care will give them more income. Instead, paying physicians for value provides the patients with the best possible care, while the physician is getting a return. It is also about how physicians take risks and manage their patient's care. They can also take part in a shared-risk model. This gives physicians who have good outcomes get a share from the risk model.
He touches on oncology units. This is not the best way for value-based, because they do not have the best outcomes. This may not be due to their practices, but because of the disease prognosis. However, they sat down and discussed ways that they could be more effective, and how they could be compensated based on them adopting these practice (i.e. palliative care, home care, etc.).
I think this is the best way to compensate healthcare providers. For everyone, they are receiving the best outcome. The patients will know they are getting the highest quality health car, because their physicians are motivated by incentives to provide excellent care. To me, this system seems to be ideal moving forward.
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