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Open Mike - 2011

Looking back, and ahead: reflections on my first three years
September 17, 2011


I’m pleased and honored that the GHP Board of Directors supports my leadership, and that they’ve expressed that by renewing my contract as president and chief medical executive. It’s good to have a job these days—especially one as interesting and stimulating as this job has been.

The last three years have passed quickly, largely because I’ve had such an amazing group of people to work with. What you’re capable of no longer surprises me. It inspires me. You’ve also been patient with me through my learning curve, and I thank you.

Getting started in 2008, one thing I knew I wouldn’t be very good at was accepting things that I couldn’t change. Yet I knew I’d have to summon the focus and peace of mind to draw people together around the things that we could change.

Looking back, I’m really proud of what we’ve done together, building on so much great work that came before. I can’t say enough about how frontline staff, local chiefs and our group practice leadership team have worked to realize the value of getting care in our group practice.

Research by Milliman shows we now deliver a significant cost advantage in our most integrated clinics compared to competitors. Consider the difference this makes to a big employer like King County. Dow Constantine himself has said he thinks the county could save more than $50 million in health care costs if all county employees paneled with a Group Health Physician in a Group Health Medical Center. And this is coupled with a #1 ranking by the Puget Sound Health Alliance through all five of their Community Checkup reports. That’s realized value.

The market sees our value too. Since 2009 we’ve welcomed 87,000 new members and 54,000 of them choose to get care in Group Health Medical Centers. Clinical costs have remained nearly flat, while quality and patient satisfaction have continued to improve.

I’ve also learned a lot about leadership in the last three years--how improvisational it can be. You offer a hypothesis, knowing it could turn out to be totally wrong. You ask questions, assessing what you learn against your hypothesis. Then, you mobilize people and resources around what must change, acknowledging very real, very human fears and feelings as you continue to improve. Above all: try to preserve what works and always tell the truth.

Group Health is a consensus-loving organization. It’s in our roots. We all just work better when we know we have been heard—even if the final decision isn’t exactly what we hoped for. One of my goals for the next three years is to help define and spread a cohesive model of leadership, one that fits with our culture, and better hears and respects people. One that preserves what works while changing things that are holding us back.

It will fit well with Lean, which is a great set of tools to bring leadership strategies to life. What I’m talking about is a greater emphasis on adaptive leadership. We will be teaching more of the skills, behaviors and attitudes that make adaptive leaders, and you’ll hear much more about this in months to come. 

Let’s keep in mind that major challenges we’ve taken on in recent years (medical home, EDHI, the spread of shared decision making) have been adaptive challenges, and we’re already meeting these challenges admirably.

Looking ahead I think about a quote from the microbiologist Jonas Salk, who said our greatest responsibility is to be good ancestors. I’m thinking about the Group Health of the future, and about the people who are ready to roll through the next 65 years together.
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Open Mike Articles
  • 2012  
  • |  2011  
  • |  2010  
The Path To The Best Care At Lower Cost   12/01/2012
The US spends $2.7 trillion on health care every year. If our collective wallets feel lighter, that’s because $304 billion comes out of our own pockets. How can these kinds of costs be brought under control, without sacrificing quality of care?

Certainty   09/04/2012
Sustaining momentum in uncertain times can be hard, but one way to keep it up is to celebrate progress. I’m really proud to call your attention to a study published in Health Affairs today.

Affordable Care Act ruling brings stronger imperative to transform health care  07/11/2012
As important as the Supreme Court Ruling is for the future of health care, it’s really just one step in a process that started before the Affordable Care Act passed and will continue for a long time to come.

Only connect 05/16/2012
This spring I spent five weeks in clinical immersion all over our system. I had 34 small-group discussions with 172 different clinicians. In March, I shared some early insights at the half-way point. Now I want to wrap up everything I heard.

What if? 04/11/2012
What if the “new normal” doesn’t feel normal at all, for many years? I try to remind myself and others that the current turmoil in health care is driven by market forces—not politics—and can only be solved by directly addressing the market. Our “new normal” is all about reaching across silos to work with partners in new ways.

Business problem? Diagnose it.
03/21/2012
I’m about halfway through my 2012 clinical immersion. When I tried this last year it was new for all of us, and it felt right to start our conversations around values. This year I'm trying to dig a little deeper.

What will your legacy be?  02/24/2012
What a night! It felt terrific to see over 700 clinicians and special guests at the GHP Annual Meeting on February 15. “A Legacy of Leadership” was our theme for the evening, touching on our shared past, present, and future.

Performance matters  10/19/2011
Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s Medicare Advantage plan is one of them!

Our people are our culture, and we’re constantly evolving  8/17/2011
One thing I’ve noticed since my last Q&A on Group Health culture with Scott Armstrong is that conversations like ours are spreading.

More than elbow room  7/6/2011
Growth is a good problem to have in turbulent economic times. But as I’ve heard in medical staff business meetings and conversations, growth is hard on daily life at work.

Erikson and Soman on partnership and growth  6/15/2011
Sustaining growth isn’t about Michael and I being leaders; it’s about teams of seasoned, excellent colleagues and leaders and clinical teams. We both have tremendous confidence in them.

The good, the bad and everything in between  5/11/2011
I went all over the state in March, talking with small groups of GHP physicians and other clinicians about critical issues. 

Why are we here?  3/23/2011
Easily eight out of ten of you mention that our philosophy of medicine—the way we practice—drew you here. And paired with the people and relationships in your workplaces, it’s a major thing that keeps you here.

Culture at Group Health: 7 questions for Scott & Michael  3/9/2011
Scott and I kicked off some fresh thinking about culture and respect for people at our Leadership Conference about five weeks ago. Recently, we sat down to check in with each other about it.

Put some passion in your workplace 2/17/2011
What satisfies you, motivates you, or makes you want to tell your friends and family about your day? Do you know how your co-workers would answer these questions? Talk to each other to learn from each other.

Sometimes growth don't feel like it should  1/28/2011
We know that taking on new patients—and engaging them in their own good health—takes time. But it’s what’s unique and important about our kind of medicine.

What will it take? You.  12/1/2010
About 350 leaders from the Group Practice and throughout Group Health gathered for the Group Practice Annual Fall Forum on November 12.

Demystifying clinical integration
11/3/2010
Clinical integration is the key, so let’s define what that phrase means.

Step back and take it all in. You’re making great things happen.  10/21/2010
In the last issue of Open Mike we had just learned that we had won the 2010 Acclaim Award from the American Medical Group Association.

Group Health sees a big jump in NCQA private plan rankings  9/22/2010
Group Health is one of the highest rated health plans and among the top 50 in the nation, according to the National Committee for Quality Assurance (NCQA).

Innovation is where we shine  9/8/2010
I am very excited to share that the American Medical Group Association (AMGA) has honored our work with its 2010 Acclaim Award.

Notes from the Colorado Health Symposium  8/11/2010
During the last week of July I traveled to the Colorado Health Foundation’s annual symposium in Keystone, CO.

Measuring up  7/28/2010
Quality. Ask a hundred people to define it, and you’ll get a hundred answers.

The risk and opportunity of Accountable Care Organizations
6/30/2010
Shared values, physician-led care models, and aligned incentives can bridge the distance between organizations in the world of accountable care.

Let’s start a conversation about our workplace  4/4/2010
People are our most important resource, our “secret sauce.”

Decreasing “unwarranted” variation in clinical care  3/24/2010
As you read this, we are in the midst of unprecedented reform to our national health care system.

Making the transition from “I” to “we”
2/10/2010
Last night the Group Health Permanente Annual Meeting left me feeling inspired and confident.

Looking ahead to 2010  1/13/2010
First, for 2010, our goal is as follows: We will lead the top delivery system in the state.

Other GHP Leadership Publications