A Shift in Leadership
Despite the many challenges independent pediatric practices face, East Bay Pediatrics is leading the way when it comes to adapting to the new realities of the healthcare system.
For Dr. Oken, that has meant mentoring a new managing partner over the course of three years so that she’s well-versed in the nuances of running the business. Dr. Vo says she feels grateful to have inherited leadership of a practice that is thriving in many ways. After taking over as managing partner in May of 2015, she has been working to make the practice more efficient, a process that includes transitioning completely away from paper reports and records. She’s also building a solid foundation for the future by involving the entire staff in strategy sessions that are designed to tackle big picture issues like remodeling or renovating locations, or plans for nurse staffing.
“I don’t want it to be my vision,” she says. “I want it to be a practice vision.”
Her participation in the AAP’s Pediatric Leadership Alliance, a program focused on developing in pediatricians skills related to team leadership and systems thinking, has helped her learn how to bring a group together around a common goal.
East Bay Pediatrics’ team of registered nurses – many of whom do the bulk of phone triage – are a unique asset for the practice, says Vo. She sees potential for their role to grow, creating a model of collaborative teams that improves patient care and keeps costs down.
“I’d like them to focus their continuing education so that they can each become an expert, whether that’s in school health or newborn care or nutrition, so that we have those experts in our office,” she says. “I think it can really benefit how we can give care.”
With the nursing team focused on education, the physicians can handle the patient’s clinical needs, divvying duties in a cost effective way.
Despite the sustained pressure on independent practices to cede control to larger groups, Dr. Vo sees the benefits as continuing to outweigh the costs when it comes to their current practice.
A failed merger with two different independent pediatric practices cemented just how many variables need to align to make a plan like that come to fruition. Different philosophies around staffing models and compensation plans helped to contribute to the demise of the effort, says Dr. Vo. And since one of the practices did not use an electronic health record system yet, the timeline for implementation of any merger would have been a long one.
“We realized that we were way more different than we thought and it really wasn’t going to work for us,” she says. “But we made the effort because there’s definitely that sense of fear that all of this stuff is changing around us and that we’re going to get kind of pushed out.”
And although some pediatric practices in the area have joined larger systems, Dr. Vo says she continues to have concerns about compensation practices and quality measures that don’t seem to take into account the unique nature of pediatric practice.
“There was an obvious misunderstanding of where money comes from for pediatrics,” she says, “and there was an obvious lack of pediatrics in all of the groups, meaning that you would be starting from scratch.”
Plus, East Bay Pediatrics’ independence allows them to meet patients where they are; for example, when a family lost their employment in a recent economic downturn, the practice was able to work out an arrangement for payment until they got back on their feet. The goal, says Dr. Vo, was to remain “a stable medical home for the children when the rest of life dealt them a blow.” Patients benefit from the practice’s ability to remain nimble and flexible in handling difficult situations on a case-by-case basis.