Recap of Becker's Panel Discussion on April 4

By Dr. Michael J. Zappa

On April 4th, I had the privilege of participating in a panel discussion with Dennis Jolley, Vi-Anne Antrum, and Alan Lieber centering around the challenge of being a comprehensive hospital system vs one that is specialty focused. Alexis Reynolds did a wonderful job moderating a very though provoking discussion.

It is no surprise that there is a simple direct answer; the most accurate answer is it depends. It depends on your location, your competition, your resources, and degree of integration.

There was uniform agreement that market forces will continue to drive consolidation, but consolidation itself does not guarantee integration. Where a system is in its journey toward integration defines what duplicative services make sense to consolidate and what services need to stay very close within the community.

As pointed out by Mr. Jolley, there are specialty hospitals that have a very narrow focus and mission, yet there are many more examples of the hub and spoke model in health systems today. The traditional model usually keeps core services at the spoke hospitals and specialized complex services at the hub, or tertiary referral center. Some systems, such as Cape Fear Valley, have modified the traditional model and use two spoke hospitals to provide very specialized care including ophthalmology, plastics and joint replacement.

Success in this arena of consolidation, integration and specialization requires hospital executives and physicians to be aligned around strategic goals. This begins with "a call to conversation" well before a final decision is made. It is not enough to have clinical input come from the CMO and CNO and call a meeting with the rest of the physicians to seek their input on how to operationalize the strategic goal that has already been decided.

This is where the art of communications is so important; to transcend the gap between just talking and actually communicating there must be trust...it is built over time, but begins with frequent open dialogue. A key element to success rests upon the ability of each party to speak the other's language.

Finally, never lose focus on the most essential element: care of the patient. Knowing the right thing to do in healthcare is easy -- just think what you would want for your own mother or beloved family member; the challenge is the execution and universal application.

Thanks again to Becker's, my fellow panelists and moderator for the opportunity to share our successes and challenges.