Leadership Reflection Paper

After attending module one of this course I learned to believe that I don't have to be far very advanced in my career before looking to exhibit leadership qualities or behave like a leader. In fact it is recommended and accepted to start your path to becoming a leader way before you achieve titles such as Manager or Director. Module one I took away an important lesson which was to acknowledge your mistakes so that you become more connected to your staff and take corrective action/ make them part of your next moves decision making. The main takeaway point I consider was that "Leadership can be developed, but it takes time" as referenced in course Power point presentation. I also agree with the point that we want leadership, but we kill it especially in my profession of medicine, where leadership yields low everything, from employee performance to health outcomes to setbacks to the furthering of the institute if there are poor performing leaders in place. Other powerful moving statement was the quote by Peter Brabeck "what I want most for nestles is for everyone to do a little more bit by bit, day by day. It is very much in line with what I believe in and would find be helpful in the healthcare industry in order to get results.

Another striking point to me was that some leaders have superb situation sensing skills, which I find to be very helpful, and a skill requiring attention and mastery by all leaders. This will perhaps make the difference of becoming CFO at age 45 versus 65.

Module 2-

Motivation and Performance are intrinsically correlated and crucial for success of the organization. I find them very important to focus on as a person in the medical field and to see how this can benefit the entire population. There are clearly parameters and endpoints that can be measured easily and others not so much. It is interesting that we can measure some skill sets, experiences and then tie them to rewards but effort/energy as well as motivation/intensions not so much. This module has been through and allowed me to contemplate about the implementation of the new Physician Value Based Payment Modifier that uses certain metrics and targets. It is well know that physicians are leading patient care teams and are big decision makers for system-based investments, which facilitate overall quality improvement. The class lecture reminded me of the time I worked as a physician in one of the public hospitals, located in Puerto Rico. During that time I saw the setback of the compensation and reward policy formulated by the executives. The policy was attempting to correlate performance in terms of health objectives with net compensation.

In 1995, Puerto Rico underwent a change in its health policy, transforming the health care system into a managed care system. The new model increased the access to managed care by providing a wider net of providers to the medically indigent. This system discouraged referral to specialists and the prescription of costly medications. Primary care physicians therefore were less inclined to prescribe comprehensive treatment plans for patients with chronic illnesses, which then resulted in an exponential amount of patients presenting to emergency departments, which further burdened the healthcare system. This type of compensation based on performance contributed to reluctance among physicians to accept patients with this insurance as well as the chronically ill, because of the lower reimbursement payment scale, which became a barrier in getting good health care. The actual intention of the plan was to emphasize preventative medicine and reward primary care physicians. But the current health policy made it difficult for providers to deliver high quality care. It is predominantly due to having to enroll volumes of patients in order to maintain a minimum net income. Specifically, this policy needs to be revised so that primary care providers do not feel hesitant to prescribe continuity care and long-term medications to patients suffering chronic illnesses, or to refer patients who require sub-specialty care to specialists.

To ameliorate this situation, I would have hired extended health professionals such as nurse practitioners to work alongside physicians to manage most of the preventative medicine goals such as Hypertension and Diabetes management and including patient education. At the end of the year based on selected parameters such as decreased emergency room visits or premature coronary artery disease etc then determine a team based monetary reward for them. This in the long run will decrease health expenditure, morbidity, and mortality and improve overall quality of care. For some of the specialties I see fee for service as being viable option when in tandem with extended health professionals such as standard physicians visit or consult for a specialist. This will require a greatly orchestrated healthcare team with a high level of camaraderie. Overall, this should decrease direct labor costs because the physicians will be contributing less effort per patient at their higher salary. The downside of this will be perhaps higher malpractice insurance and level of liability when you delegate so much to non-physicians.

Module 3 Entry

This module helped me to think about Human Resources and its importance to success of an organization and leadership. The theory of Herzbergs complex theory application can be seen in everyday life. It is a paradox that is observed especially with hospital employees who may be under lots of stress and wanting recognition. This reminds me of the way Human resources department handled the situation at my hospital.

The Human resource professionals are usually involved with employee relations and are exposed to a wide variety of situations that call for different behaviors. Because of the sensitivity, confidentiality and potential liability of many of the issues HR professionals address, HR employees are expected to behave in a professional, confidential, compassionate yet stern manner. These are essentials qualities of the human resources personnel that in my opinion are lacking. And this has many overall consequences. At the hospital, where I was at for about three years, I saw the frustrations of the staff when it came to unfair treatment by their supervisors regarding time-off as well as their salary. For example, if a physician was not paid properly according to the invoice he or she submitted they did not feel confident that they could take this issue to human resources or for any other requests. The overall feeling was that these people are just puppets to the trustees of the university and there is no point of pursuing any issue. It seems pointless to me to have and maintain a human resources department that is not capable of getting