• Cultivating Physician Leaders at Iowa Health System

    May 14, 2012

    By Laura Ramos Hegwer

    After adopting a strategic plan to become a physician-driven organization, Iowa Health System built an academy to groom physician leaders and drive systemwide strategic initiatives.


    Nearly two years ago, Iowa Health System (IHS), Des Moines, Iowa, launched an academy to prepare promising physicians for future leadership roles in the organization. "We had a growing need for physician leaders, and we knew there was good raw talent in house, but it had to be harnessed and developed," says Alan Kaplan, MD, senior vice president and chief medical officer, IHS, and president and CEO, Iowa Health Physicians.

    In 2010, the 15-hospital system turned to the American College of Physician Executives (ACPE) to help develop what would become the IHS Physician Leadership Academy. In just three months, Kaplan and Emily Porter, vice president of people excellence, designed the leadership curriculum and application process for the academy.

    In July 2011, the first 36 physicians graduated from the academy with a formal graduation ceremony. The second group, which includes 40 physicians, will graduate this August. At press time, IHS was planning its third year of physician leadership development.

    A Mix of Online and Onsite Coursework

    The academy offers a 12-month curriculum that combines self-paced, online courses with group, onsite education sessions that bring the physicians together once a quarter. The combination of onsite and online sessions helps keep costs down.

    Courses range from financial decision making to "soft skills" such as effective communication. Faculty are nationally recognized speakers provided by ACPE. During the quarterly group sessions, IHS leaders also serve as faculty, offering their perspective on the health system's path toward becoming an accountable care organization (ACO), among other topics.

    The quarterly onsite meetings have been particularly valuable for fostering camaraderie and teamwork among up-and-coming physician leaders, says Kaplan. "The relationships that have been built during these onsite meetings have been important for our development as a system."

    In particular, having a core group of motivated, team-oriented physicians has helped smooth the transition to IHS's newly aligned medical group. The still unnamed group, launched in January, is the result of IHS buying and merging multiple regional physician groups into one organization. The groups ranged in size from 10 to more than 270 providers.

    Currently, the medical group includes more than 470 IHS-employed physicians with another 300 expected to join later this year. Several recent graduates of the IHS Physician Leadership Academy are involved in managing the new medical group, which is the ninth senior affiliate of IHS. Like IHS's hospitals, which comprise the other eight affiliates, the medical group has its own board of directors with delegates to the parent board.

    Projects Tied to System Initiatives

    While enrolled in the academy, physicians participate in projects that give them hands-on leadership opportunities in support of the health system's strategic goals. Some physicians enrolled in the academy are working on projects that will help IHS become ACO ready.

    Many others are focused on IT. For example, one physician designed computerized physician order entry order sets and trained the medical staff at her critical access hospital on how to use them. In addition, several chief medical information officers who are enrolled in the academy are helping the IHS's regional hospitals roll out a new electronic health record.

    The Few, the Chosen

    Only about half of physicians who apply are accepted into the academy. In the first year, enrollment was limited to employed physicians, a pool that includes more than 800 physicians. But IHS has since opened up the program to a select number of independent physicians, drawing from more than 2,600 physicians affiliated with the system.

    Kaplan says the ideal applicants have already shown an interest in system leadership by volunteering for committees or projects, such as medical home development. Not surprisingly, IHS turns down applicants who cite being "burnt out from clinical work" as a reason to explore leadership opportunities in the system, he adds.

    After the academy staff screens the applications, they ask leaders in the physicians' region to rate the applicants for leadership potential.

    Over the course of a year, physicians earn 113 CME credit hours that can be applied toward a Certified Physician Executive (CPE) designation, a master's degree in business administration, or another master's level program.

    Once physicians graduate from the program, Porter helps connect them with other IHS leaders who serve as mentors to help graduates develop their potential.

    An Investment in the Future

    In addition to improving physicians' team-building skills, the leadership academy has helped foster trust between the health system and the medical staff, according to Porter, who cites interviews with recent academy graduates. "They see the investment that we are making in them, today and in their future."

    Laura Ramos Hegwer is a freelance writer and editor based north of Chicago.

    Interviewed for this article:

    Alan Kaplan, MD, is senior vice president and CMO, Iowa Health System, and president and CEO, Iowa Health Physicians, Des Moines (KaplanA@ihs.org).

    Emily Porter, is vice president of people excellence, Iowa Health System.