Transforming the physician enterprise has long been a goal of boards and management, but pandemic-related pressures have pushed it to the top of the agenda in 2022.

Chartis Chief Physician Executive Roger Ray explains why improving the physician enterprise—“the most vital organ of a health system”—is critical now and how to get started.

A former practicing neurologist and experienced health system physician executive, Roger is a practice leader of Chartis’ Physician Enterprise Solutions. He leverages his 30 years of healthcare leadership experience to transform physician enterprises into value drivers for health systems and medical groups. Outside of work, you can find Roger working on his latest woodworking project.

Chartis: What are the forces impacting the physician enterprise today?

Roger Ray, MD: 

The challenges facing physician enterprises have existed for some time, but the pandemic catalyzed them further—accelerating economic pressures, complexity in the clinical environment, and workforce staffing and burnout issues. However, it also brought the acceleration of virtual care in many settings and innovation of the care team model.

Chartis: Workforce is certainly a hot topic heading into 2022. How does it relate to transforming the physician enterprise?


The previous somewhat narrow issue of physician burnout now superimposed on the overall healthcare workforce has made it clear—improving the care team environment is Job One right now, and the whole industry needs to get its collective brain around it and chart a better path. The path we have been on isn’t sustaining, which we could see when stressed by something like the pandemic.

We have to very carefully, but aggressively, innovate on the care model and enable the unique contributions of all care team members. We need to create a sustaining environment for our caregivers and at the same time double down on our cost improvement efforts.

Chartis: How does transforming the physician enterprise relate to other priorities health systems have?


As health systems and medical groups look ahead, achieving nearly any significant strategic ambition for the system will require a mature, high performing physician enterprise at its inner core.

Whether it’s care transformation, going at risk, utilizing technology better, innovating on the care team — none of those initiatives can be achieved without the provider enterprise fully engaged and driving significant portions of these changes. That’s why it’s more critical than ever that organizations understand the maturity and performance of their physician enterprise. A high performing physician enterprise will not only be a differentiator in the marketplace but unlock the ability to achieve other strategic goals.

Chartis: How can healthcare organizations find the bandwidth to take advantage of these opportunities?


The simple answer is that organizations have to find a way to be proactive and prioritize these opportunities, or else they will find themselves reacting to the negative implications.

The more complicated answer is that organizations have to find a way to build upon what they’ve already learned from the early days of the pandemic. Organizations proved they could communicate effectively in challenging times, and they proved they could be agile in changing care delivery. They need to tap into those learnings and reinforce those behaviors to take advantage of the mid- to long-term opportunities afoot.

A lot of organizations fall back into their old management systems when they’re no longer in crisis, and the thing to remember is that we are not going back as a society—so healthcare organizations can’t revert either.

Chartis: What should organizations assess to understand their physician enterprise’s performance?


The three biggest tasks to improve a physician enterprise are first to fully define and measure value, so one can improve value creation for the system, patients and providers who are part of the enterprise. Next, gain clarity on how you stack up against best practices in the nation—as soon that will be the competition. And finally, focus in on the overall strategic plan of the organization and how the unique contributions of the physician enterprise need to support it. If you focus there, you can move the needle on the dimensions that are truly differentiating.

Chartis: How would you recommend organizations get started on understanding their current state?


As you look at the physician enterprise, leadership needs to simultaneously create great pride in all the things they do well while maintaining a relentless focus on improvement. An organized and objective assessment that looks at 10-12 dimensions of performance and maturity will provide that perspective.

In my experience, the three dimensions where we most commonly see improvement opportunities are adapting technology for its best clinical uses; innovating on the care model and care team model; and getting the right incentives in place to drive value-based payment.

Chartis: Any final thoughts?


In many organizations, the provider enterprise has always been somewhat important, but it’s been limited to being an interesting way to engage stakeholders, fuel improvement and gain buy-in. Now, essentially everywhere, it is becoming a vital organ of health systems.

Forces for Change is an annual trend outlook report from The Chartis Group focused on defining the forces shaping healthcare today and outlining what health systems can do to prepare for what’s next.

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© 2023 The Chartis Group, LLC. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors.

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