Kenneth H. Cohn T'98
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"I preach revolution disguised as evolution."
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Helping Hospitals Work Smarter
Sometimes an MBA is just what the doctor ordered. In 1996, after having been laid off as a surgeon because of budget cuts at a Veterans Affairs hospital, and feeling disenfranchised as a doctor, Ken Cohn decided to enroll at Tuck. He was in his mid-40s, with no prior business experience. Two years and many spreadsheet models later, he was voted class Investiture speaker and now enjoys putting his business training and teamwork skills to work as a healthcare consultant for the Cambridge Management Group.
As the oldest student in his Tuck class, Cohn passed up the party scene but nevertheless endeared himself to classmates by volunteering for tedious assignments (such as writing first drafts of group papers) and asking questions in class that others were afraid to ask. "My willingness to admit cluelessness helped," says Cohn. Tuck also offered a sharp contrast from his previous graduate-school experience. "In medical school, there was a lot of memorization, whereas at Tuck more than 30 percent of my grade came from team projects."
Together with his firm's partners, Cohn applies a unique, physician-centered approach designed to improve physician-to-physician and physician-to-administration communication. "Traditionally, consulting firms are hired by hospital administrators who believe that their organization is more or less OK but could just use a few technical adjustments," he says. Doctors, on the other hand, often have a different perspective. In today's increasingly bottom-line-oriented healthcare system, doctors can't control their work environment. Administrators can unwittingly add to physicians' workloads or take away responsibilities without giving physicians a say in the process. The result is disgruntled doctors and a less productive work environment.
Cohn and his colleagues approach doctors at community hospitals and help them put together a structured dialogue among their medical colleagues. The dialogue produces wide consensus for specific recommendations. With essential help from administrators—who support the process with encouragement, information, staff, and consulting assistance—issues once seen in terms of "we and they" are reframed as shared opportunities important to the physician-hospital enterprise. "Treat doctors like adults, and you'll get adult responses."
Frequently, the recommendations and results are far-reaching. "I preach revolution disguised as evolution," jokes Cohn. At one New England community teaching hospital, for example, the CEO changed the hospital's strategic positioning from "high-tech" to "best patient and physician services" and thereby significantly increased revenues and volume. Cohn's firm has consulted for more than 50 hospitals nationwide during the past 15 years, and in all but one case the physician-physician dialogue effectively engaged medical, nursing, and technical colleagues as well as hospital management, resulting in an improved practice climate. The one exception involved a disruptive physician. "It's like a party," says Cohn. "You have to invite the right people."
Cohn says most doctors are delighted to have a fellow physician with business skills help them level the playing field. "Physicians are being squeezed as expenses increase faster than reimbursement. Working harder is no longer a sustainable solution," he says. "We need to learn how to work smarter."
When he is not consulting, Cohn still finds time to practice surgery, covering practices of general surgeons in Vermont and New Hampshire. He has written a brief book, Better Communication for Better Care: Mastering Physician- Administrator Collaboration, that will be published by Health Administration Press in March 2005.
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