International ACHE Profile:
Joe F. G. Ledesma
President and CEO
St. Luke's Medical Center
"With the push for medical tourism (the huge potential of millions of international medical travelers—fact or hype, depending on which studies you believe), it is imperative that healthcare executives maintain the highest standards of professional and business integrity."
Q: Tell us briefly about your background in healthcare management.
A: I graduated with a degree in chemical engineering from the University of San Agustin in my hometown in Iloilo City, Philippines, in 1967, and worked for nine years in pharmaceutical sales and marketing. I then became CEO of a 150-bed community hospital in the same city.
I joined St. Luke's in April 1981 as hospital manager and became executive director and COO in 1986. In 1996, I was appointed president and CEO. In January 2010 we opened a second, 620-bed hospital. I now run both St. Luke's Medical Center-Quezon City (630 beds) and St. Luke's Medical Center-Global City as concurrent president and CEO.
Q: What is the biggest challenge you face in your current position?
A: After 28 years of successfully marketing St. Luke's as the country's most expensive hospital, the market suddenly became price sensitive when we opened our second hospital last year. Because the new facility looks like a five-star hotel, the competition has successfully painted it as a very expensive hospital (despite rates being exactly the same in both hospitals). Many customers are now afraid to come to us. The challenge is how to change this public perception without cheapening the St. Luke's brand.
Q: What is the biggest reward?
A: The construction and opening of our second, state-of-the-art, 620-bed hospital with 70 percent of the cost funded by internally-generated funds and only 30 percent financed by bank loans.
Q: Briefly describe the healthcare atmosphere in the country in which you work.
A: The Philippines is a developing country with a population of around 90 million. Healthcare is generally inadequate outside of the major urban areas, but the major hospitals and the professional expertise in the big urban areas of Metro Manila, Cebu, Iloilo and Davao are of high caliber. For example, St. Luke's claims that its two hospitals are better equipped (except for electronic medical records) than 95 percent of U.S. hospitals.
There are around 1,500 hospitals in the country, of which roughly half are private. The rural areas are served by rural health centers with almost no medical equipment. Less than 10 percent of the population has private health insurance. There is government-mandated health insurance for both private and public sector employees, but this pays only a fraction of hospital and professional-fee charges in major hospitals.
Thus, the overwhelming majority of patients are individual, self-pay patients; at St. Luke's, the mix is 60 percent individual/self-pay, 22 percent HMO/insurance, 10 percent corporate accounts and 8 percent charity patients.
Q: How do you see the field of healthcare management changing in the next five years?
A: If the promise of genetic biomarkers and gene therapy materializes in the next five to 10 years, healthcare managers will have to scramble and think outside the box to address tremendous revenue losses because of reduced utilization of highly-profitable diagnostic and therapeutic procedures.
Q: What advice can you offer for other international affiliates?
A: With the push for medical tourism (the huge potential of millions of international medical travelers—fact or hype, depending on which studies you believe), it is imperative that healthcare executives maintain the highest standards of professional and business integrity.
Universal Strategies for Physician Engagement
By Megan Downey
At healthcare organizations around the world, engaging physicians is essential to achieving the organization's strategic plan. While the definition of the relationship between hospitals and physicians changes depending on any number of factors—geographic location, governmental regulations, customs and culture, etc.—certain strategies stretch across all boundaries.
Here, four healthcare management professionals at differing organizations offer their universal strategies for physician engagement.
Dr. Harish Pillai
CEO, As-Salam International Hospital
As-Salam International is a tertiary care hospital that employs physicians on a fee-for-service model.
- Make physician retention a priority if multiple organizations in your area are fighting for the same pool of physicians.
- Focus on quality of care; physicians will ultimately be driven by the choice or demand of their patients.
- Consider capital investments to provide physicians with access to desired and/or cutting-edge technology.
- Ensure proper management of your finance division to guarantee timely pay.
Director, Frontline Consultants
Deffenbaugh consults on leadership strategies in hospitals throughout the U.K.'s national health system.
- Build a coalition for change. Change will only come when people want to change, and it will be peer-to-peer engagement that enables it.
- Physicians respond to evidence. Provide robust, transparent evidence so that everyone is making decisions on a level playing field.
- Medicine frequently does things to the customer rather than with him. There is a professional-centric focus in the profession, and patient stories can be used to shift the balance toward how the customer feels and what he wants out of the partnership.
- Support change through coaching. Leadership is a lonely place. Give physicians someone to talk to, and tailor that relationship to the physicians' needs or requirements.
Development manager, Empresas Banmédica
Empresas Banmédica is part of a 1,500-bed healthcare provider that employs 4,000 physicians at hospitals throughout Chile, Colombia and Peru.
- Treat physicians as partners. They need to feel that the hospital values their contribution.
- Build a strong administration that serves with efficiency.
- Give physicians the tools they need.
- Be clear about financial matters, and give them access to financial information.
CNO, Saad Specialist Hospital
Al Khobar, Saudi Arabia
Saad Specialist Hospital is a private tertiary care and referral healthcare facility.
- Engagement starts with potential candidates. This process has to be smooth and not all about money.
- Build a culture in which safety is well rooted in the organization and practiced at every patient encounter. Nurses play a huge role in ensuring that physicians comply with safety practices.
- Physicians should be given the time to contribute and be active members in multidisciplinary teams and task forces.
- In the private sector, physicians are usually employed by the hospital rather than independent practitioners. This can help in engagement if the organization shows respect and value to its staff. Less control and more accountability will encourage doctors to be loyal members of the organization.
Below are new ACHE resources such as books, study courses and websites to help you excel in your career.
Reaching Excellence Series
This series includes the following self-study courses:
- Building Clinical Systems that Produce Excellent Outcomes
- Building the Foundation for Healthcare Reform
The Art of Hiring the Right Employees
Hiring new staff is a challenging but critical process. Here are some tips for the candidate search.
Know who you really want.
Identify the experience and qualifications needed to fill the position by creating a comprehensive wish list.
Implement a three-pronged approach.
Advertising online is a proven way to attract candidates. However, make sure that your advertising communicates the benefits of the position and your organization.
The more people know about your organization, its management style and what it offers employees, the easier it will be to attract the caliber of candidates you seek.
- Partner with a search firm
The nature of the staffing industry is to continuously network with prospects, clients and candidates, offering services and suggestions that continually replenish its resources.
Finding the needles in the haystack.
Using the wish list you already compiled, assign a value to the experience, education or qualifications each applicant brings to the job. This "quantifying capabilities" method will bring you closer to identifying the necessary abilities a candidate should exhibit to achieve success in the given position.
Excel at the interview process.
Here are some tips and suggestions to help you excel as an interviewer:
- First impressions mean everything; this is a two-way street.
- Get the responses you need.
- Be cognizant of the job requirements.
- Delve into past performance.
- Envision the future working relationship.
Sell your company to contenders.
Once you are convinced a candidate is a contender to fill the position, you need to "sell" the prospective employee on the job, your company and yourself as the future manager. Explain the challenges and rewards of accepting this new responsibility. Stress the positives of working for your company.
Be aware of the market value of the prospective employee and your budget limitations.
Probe the candidate's interest by asking about other opportunities he or she might be exploring. Above all, remain positive—attitude will help immensely in bringing negotiations to a successful close.
Keep your options open.
Once the interview process is over, review your notes carefully, evaluate how well the contenders stack up against your wish list and pick your top three choices. Try to close your No. 1 choice first. If not successful, you still have two worthy candidates from which to choose.
Money isn't everything.
A competitive compensation package will go a long way toward attracting and retaining good employees, but it's not just money that will keep them bound to you. Today's executive wants to be involved, appreciated and challenged. The greater the opportunity to contribute and be rewarded for accomplishment, the higher morale and productivity will be.
Successful hiring is an everyday job.
Like any art form, to master the art of getting good help, you must practice it every day.
Adapted from "The Art of Hiring the Right Employees," published by Ajilon Professional Staffing, on ajilon.com. Click here for a full copy of this article.
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