2009: Open Letter to Medical Staff Department Heads

Greetings,
As we enter this new year I resume my former role of Chief Medical Officer (CMO) which I had from 1987-2000.

(Trivia: What do I have in common with President Cleveland?)

In this role I will be the point person for staffing, contracting and union negotiations. I will work under the direction of Dr. Smith and collaboratively with him and with Dianne Dunn Bowie.

2009 is going to be a tough year for money. Nevertheless, I plan during the month of January to meet with each of you to better understand your current state staffing, vacancies and needs. I will then assemble this into one document. Jeff, Dianne and I will discuss it and will make decisions about how to prioritize and deploy the few vacant positions we have, and if, when and how to obtain additional ones.

Aina Wirthlin will be contacting each of you to set up an individual one hour meeting with me. Please bring written info to describe your current staffing and data to support any requests for additions. (Deming wrote: "In God I trust. Everyone else bring data.")

More that you can expect in 2009:

In addition, Jeff and I will be working to formalize the contracting structure and process to create more predictable and transparent outcomes. Any suggestions you have regarding this would be appreciated.

I expect all clinical department heads will be involved in issues regarding the continued need, contraction, or expansion of certain contract specialties. I do not plan to meet with any contractor without having the department head in the loop.

It is likely that I will desire standing meetings with each medical staff department head individually either monthly or quarterly to maintain open channels of communications and to create an established forum for constant engagement regarding physician services. We will talk more about this at our January meeting.

Given the severe budget shortfalls that will face the county (both state and local budget issues) we have no choice but to scrutinize exactly how we assign physicians. Our principle assignments as stewards of the public's money and health are to provide quality and access. In order to do so this year we may have to challenge long held paradigms.

And finally and most important: I expect each of you to be the "local experts" for your specialties. But I expect you to transcend that allegiance to be advocates for the system as a whole and the populations that we serve. I have utmost confidence that you will.

We can make lemonade.


Steven Tremain, M.D., A.B.F.P, F.A.C.P.E.
Chief Medical Officer & Chief Medical Information Officer