Ogden Clinic's Executive Administrator received the spotlight in Health Executive. Read the full article in context at www.healthexecutive.com (reprinted below).

Paul Schofield turned this independent, physician-owned practice around by focusing on measured growth and teamwork. When Paul Schofield became administrator at Ogden Clinic two years ago, he realized that, although the physician owned practice had been on shaky ground prior to his arrival, the providers/shareholders and the governing board had demonstrated an ability to work together through difficult times. They only needed a solid and unified vision.

Schofield’s first line of business was to change the board’s focus from addressing management issues to developing a strategic vision. He realized to accomplish his goal, the board needed to better understand its role. “The board is the fiduciary of the organization,” Schofield said. “Its job is to provide and develop Ogden Clinic’s strategic vision, and it was very willing to do so.”

Schofield’s next order of business was to restructure the organization. He presented the board with a streamlined administrative structure and organizational chart that would save Ogden Clinic money. Although some employees who had been with the organization for a number of years elected to leave, Schofield said the new management team made it possible to position Ogden Clinic for the road ahead.

“The board gave its complete support of a revised management structure,” he said. “Almost immediately, we saw cost savings and increased productivity.”

Measured growth

Founded in 1950, Ogden Clinic comprises 60 providers and just fewer than 300 employees. After reorganizing Ogden Clinic’s management structure, Schofield facilitated an environmental assessment to fully understand the population demographic trends and who the organization’s main competition was.

“We shared that data with our shareholders and then took our strategic planning process to the board,” he said. “We asked the board to develop some strategic goals.”

The board analyzed the organization’s mission and vision and then established five strategic goals. “One of the board’s first strategic goals is measured growth,” Schofield said. “We wanted to make sure that, based on our financial and productivity models, we didn’t outstrip our resources and penalize the shareholders.”

The environmental assessment pinpointed an area north of the Ogden Clinic’s flagship location that was experiencing rapid growth but was largely underserved. The board decided to purchase land without indicating what kind of facility to build. That approach was not something Ogden Clinic’s investment company, OCIC, was used to.

“We showed OCIC’s board the opportunity, the environmental assessment, and the need, and they took it to the shareholders,” Schofield explained. “The shareholders voted to purchase the land, and we began construction on a 12,000-square-foot building that has the ability to expand to a 20,000-square-foot building.”

Mountain View Clinic, the sixth of Ogden’s clinic sites, will open in September 2007 and, said Schofield, has led to more measured growth. In July, the organization decided to purchase land in an area on the west side of the county and plans to build a new location in the next few years. “Every decision we make must align with at least one of our strategic goals,” he said, “and we haven’t gone wrong yet.”

Internal commitment

Ogden Clinic prides itself on having a strong primary care base and a broad spectrum of sub-specialists. For years, the organization believed the primary care referrals were staying within the Ogden Clinic, but the environmental assessment showed a large number were going to outside sub-specialists. “Once our sub-specialists were aware how many referrals were leaking out of the clinic, we sat down with all of the shareholders and developed a strategy to remedy the situation,” Schofield said.

One member of the board pointed out that, in the five years he’d been with the organization, he’d never set foot in any clinic other than the one in which he worked. The team realized the lack of socialization between the shareholders, employees, and board members was actually hurting the organization. Consequently, socialization, or a stronger internal commitment, became another of the organization’s strategic goals.

“At first it was a challenge to get everyone involved, but once they started realizing the positive impact—especially the sub-specialists—on referrals from our primary care physicians, attendance increased,” Schofield said.

In addition to measured growth and stronger internal commitment, Ogden Clinic’s strategic goals include bringing collective and individual physician incomes at or above the Medical Group Management Association average, increasing and improving community presence, and an ongoing commitment to control costs while maximizing profits. Although Schofield did much of the legwork, he credits an American College of Physician Executives conference he and his board attended two years ago for the initial push.

“The conference was well received by the board, and in addition helpful to establish my credibility as their senior executive,” he said. “Now the board requires every new board member to attend this conference to hear what his/her responsibilities are from the experts. It’s created an amazing positive momentum for the existing board members that we hope to carry into the future.”

—Amanda Barber