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What an appropriate title for the Mid-South MGMA Spring Symposium, Thursday, May 12, at the Holiday Inn – University of Memphis.

Those of you who have been in medicine for a while have seen a number of changes, from the growth of Medicare/government programs and managed care/capitation to physician practice integration (followed by disintegration) and physicians who watched their careers morph into something completely different than they had planned. Experts agree, however, that the pending transformation will make the change we have experienced to date pale in comparison.

Incoming Memphis Medical Society President Jerome W. Thompson, MD, addressed the members and guests at the 134th Annual Meeting and Installation of Officers, and referred to the old Chinese proverb that is both a blessing and a curse. The blessing is: may you live in interesting times, and the curse is: may you live in interesting times. Dr. Thompson further said in his talk that all of us would like things to stabilize into a constant, comfortable, and predictable environment for us to live our lives, raise our families and care for our patients. As he said, this is the most complex and challenging period that medicine has experienced since the 1960’s, when Medicare was introduced.

This is why, as administrators, we have to be accountable care ORGANIZATIONS. I know we have heard about ACCOUNTABLE CARE Organizations, but let’s discuss the difference.

The individuals or organizations that are accountable include hospitals, clinics, individual practices, individual physicians, surgery centers and home care, just to name a few. What are we accountable for? All parties are accountable for patient safety, quality, cost-effectiveness, patient satisfaction and physician and staff satisfaction. And who are we accountable to? We are accountable to patients, payers, both private and public, and to the public at large. Our accountability is manifest by measures of performance (safety, quality, cost-effectiveness, satisfaction) and payments based on performance.

What is our role as practice executives in the challenging period? One is that we are going to be responsible for the metrics for measuring safety, quality, cost effectiveness and satisfaction. How can we do this? We can benchmark these metrics using both internal and external comparisons to prove our effectiveness. We will be responsible for using the metrics to improve all aspects of the organization’s operations, both clinical operations and administrative operations. (William Jessee, MD, FACMPE, MGMA, January 2011.)

Our role has expanded tremendously with the change. We can use some of our existing skill sets but we are going to have to reach out as administrators if we plan to have a role in this change. We are going to be accountable more than we have been in the past.

In preparing for this massive change, Dr. Thompson is in agreement with the majority of healthcare leaders in the country, and that is: merge into larger groups or forge partnerships with hospitals as employed physicians or co-service line management and other leadership opportunities. To borrow another line from Dr. Thompson and to come to the end of this article, “Herodotus once said that the only thing that is constant is change.”



Bill Appling, MBA, FACMPE, is president of Watkins Uiberall Health Care Consulting. He has faculty appointments at the University of Memphis in the Fogelman College of Economics and Business, where he teaches in the Masters of Health Care Administration program.

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