.floatimg-left-hort { float:left; } .floatimg-left-caption-hort { float:left; margin-bottom:10px; width:300px; margin-right:10px; clear:left;} .floatimg-left-vert { float:left; margin-top:10px; margin-right:15px; width:200px;} .floatimg-left-caption-vert { float:left; margin-right:10px; margin-bottom:10px; font-size: 12px; width:200px;} .floatimg-right-hort { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 300px;} .floatimg-right-caption-hort { float:left; margin-right:10px; margin-bottom:10px; width: 300px; font-size: 12px; } .floatimg-right-vert { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px;} .floatimg-right-caption-vert { float:left; margin-right:10px; margin-bottom:10px; width: 200px; font-size: 12px; } .floatimgright-sidebar { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px; border-top-style: double; border-top-color: black; border-bottom-style: double; border-bottom-color: black;} .floatimgright-sidebar p { line-height: 115%; text-indent: 10px; } .floatimgright-sidebar h4 { font-variant:small-caps; } .pullquote { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 150px; background: url(http://www.dmbusinessdaily.com/DAILY/editorial/extras/closequote.gif) no-repeat bottom right !important ; line-height: 150%; font-size: 125%; border-top: 1px solid; border-bottom: 1px solid;} .floatvidleft { float:left; margin-bottom:10px; width:325px; margin-right:10px; clear:left;} .floatvidright { float:right; margin-bottom:10px; width:325px; margin-right:10px; clear:left;}
Though “Swap Your CEO” might sound like the name of the next reality television show, it turned out to be a great idea for two physician-owned multispecialty medical groups and the chief executives who run them.

In early June, C. Edward Brown, CEO of The Iowa Clinic, spent four days at Mount Kisco Medical Group, a 170-physician group located about 45 minutes north of New York City. In turn, Mount Kisco’s president and CEO, Dr. Scott Hayworth, spent about the same amount of time later that month visiting The Iowa Clinic, which has more than 140 doctors practicing in 37 specialties.

The idea just might put some highly paid consultants out of work.

“Here you have senior-level executives who work in different parts of the country who could offer some insight to one another,” Brown said, “and really the only investment that either organization was putting into it was time. I think both organizations felt there was a great deal of value they received out of it, for the benefit of getting that level of expertise to come in.”

“Without a doubt,” Hayworth said, “I think it was a valuable experience. I think we learned from the experience, and I think our clinics learned from the experience. Sometimes it’s good for an organization to hear from a different voice.”

“Each of us have been in our respective positions for over 10 years,” Brown said. “So we do have a good sense for what our respective organizations are like. Physician-owned and -governed large multispecialty clinics have their own set of dynamics that are unique to that type of business. It’s always nice to get together and go, ‘Oh, yeah, we’ve got those problems, too.’ It’s a validation that the issues out there are not just our issues.”

Terry Slinde, who chairs a local chapter of Vistage International, a CEO roundtable group formerly known as The Executive Committee, said exchanges like these are rare, but valuable.

“Iowa business people are generally hesitant to leave their company for a week, or to let their people take the reins,” Slinde said. “But whenever you do that, you’re really forced to grow. The ones that are generally very successful don’t wait for that to happen; they create that situation where they’re forced to see things differently. That’s real risky business, but not as risky as not doing it.”

A level of trust

Hayworth and Brown became friends after serving together on the board of the American Medical Group Association. Brown is the chair-elect of the national association, which represents about 30 percent of the physicians in the country in integrated multidisciplinary clinics.

Hayworth suggested doing a management exchange about a year ago, Brown said. “We were just having a casual discussion one evening about how much value we get out of talking with one another and (discussing) the issues that each of us have in our respective markets,” Brown said. After they agreed it was a good idea, “we started making a list of things we wanted to get out of it. From that, we decided to make a commitment,” Brown said. “Both of us are pretty busy, so getting it on each other’s schedules took a little bit of time, and you don’t really invite people to come to Iowa in January.”

Obviously, conducting such an exchange required a high level of trust from both men, Brown said.

“The other thing we felt was needed was that there had to be a great sense of openness and transparency within the organization in order to get the greatest amount of benefit,” he said. “And we said we wanted it to be something that had a value in instilling some type of potential change for the organization. This wasn’t going to be some sort of ‘Oh, let’s walk through and see what’s going on at The Iowa Clinic’ and not necessarily do anything about it.”

During his visit, Hayworth spent time with The Iowa Clinic’s management team and middle managers. Because he’s also a practicing obstetrician and gynecologist, Hayworth visited with the clinic’s OB/GYN department, and also visited with the practice’s physician leadership. Brown’s schedule was similar; both CEOs’ visits concluded with a presentation to their counterpart’s board of directors detailing their observations.

“Scott did not sit in on any of my meetings, nor did I sit in on any of his,” Brown said. “We basically allowed those meetings to be held independently of each other. We both felt like we would get more forthright information if we didn’t have any of our other colleagues in the room with us. And that actually turned out to be the case; I think it allowed for more open communication.”

Growth issues

Some of the issues that Brown dealt with at Mount Kisco were growth-related, as the clinic plans to double in size within the next year.

“We talked a little bit about medical management; they happen to be in a very affluent area, and people are changing their expectations about ease of access to physicians,” Brown said. “So more open-access, urgent-care availability was a key issue for them.

“We talked about retaining earnings, something that doctor groups don’t always do very well at, and technology opportunities. Lastly, and probably more interesting, we talked about governance. They have a very large board of directors, and I think they’re seeing for themselves that the size of their board may be inhibiting some of the things they want to do.”

Issues that Hayworth discussed with The Iowa Clinic’s managers and board included enhancing collaboration with local hospitals, physician relations and steps the clinic could be taking to enhance recruitment, retention and benefits of physicians.

“I was very impressed by the quality of care,” Hayworth said. “The physicians are very well trained and they offer a broad range of services.” He also visited the clinic expansion project in West Des Moines, which is nearing completion. “I think the community will be well served,” he said. “The facilities are outstanding.”

The executives plan a shorter exchange in about a year to follow up on issues that have been raised. They’re also considering a videoconference meeting between some of the managers at the two clinics.

“It’s always interesting,” Brown said. “You make suggestions; well, did the suggestions get implemented? Were they things that turned out to be true? Would you do anything differently? What were some of the challenges in carrying out the recommendations? Those are the sorts of things you’re curious about.”