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MAY/JUNE 2004

HARVARD MACY INSTITUTE

Executive course for European health care leaders to focus on driving change

For most of the twentieth century, the health care systems of Europe were quite successful in providing quality care to all members of their societies. Universal access has been the major emphasis of all Europeans health care systems, with cost-efficiency and, more recently, quality sometimes sacrificed. Forces of demographics, economics, technology, and societal expectations now demand rapid changes led by health care professionals who understand change processes, leadership, management, and public relations.

Today the European health care industry is in flux, with dramatic reforms of everything from medical education to health care delivery models challenging traditional views. The impact of these changes stretches from the operating room to the boardroom—they are philosophical, structural, and cultural. Across the continent, health care leaders, whether they head up public or private entities, are seeking answers to a range of questions about not only what they should be doing to advance health care, but how they are to lead and support innovation in the new century.

The Faculties of Ludwig Maximilians University (LMU), Harvard Medical International (HMI), and the University of Geneva have designed a unique educational opportunity with these questions in mind. The Executive Leadership Course for Health Care Professionals, which will be held in Venice, Italy November 28-December 3, will bring together a diversity of educational expertise and regional experience to provide leaders in health care and academic medicine with the strategic insight critical to navigating today’s dynamic health care community.

New skills for the twenty-first century health care leader
Each activity of the six-day program has been designed to support institutional projects being undertaken by the participants. From defining an organizational vision, to harnessing the power of innovation, and managing the complexities associated with funding and public relations, the program will offer participants the knowledge, skills, and strategies that have helped leaders across a wide spectrum of industry drive change and lead innovation. Participants will leave Venice with the first critical steps of a strategic plan for their respective projects. Leaders are encouraged, though not required, to attend the program as a team, as coming as a working group carries significant advantages.

The Executive Leadership Course for Health Care Professionals promises to be an energizing experience, using interactive, hands-on learning exercises and drawing upon practical experience to illuminate the course concepts. Developed in collaboration between LMU, HMI, and the University of Geneva, the program utilizes some education modules that have been designed by the Harvard Macy Institute for its annual professional development programs. The Institute leverages the knowledge and expertise of faculty across the wider Harvard University network, as well as international partners, to develop the latest principles of leadership.

Dr. Elizabeth Armstrong: “There is no shortage of ideas, or people willing to step forward and champion them.”

Dr. Elizabeth Armstrong, who directs the Institute and is one of the Venice course’s faculty, said that the program was developed in response to a common complaint among health care leaders. “There is no shortage of ideas, or people willing to step forward and champion them. However, what many leaders discover is that the process of implementing sustainable organization-wide changes is fraught with obstacles,” she said.

Those obstacles usually fall into one of two categories—people and systems—and changing one without changing the other can produce more frustration than progress. What seems certain now is that change isn’t an option for Europe’s health care systems. It’s a necessity.

Older and wiser: the patient as consumer
The shift in the European health care delivery model really began with the second World War, the end of which resulted in spikes in the birth rates of several countries. Today, the birth rate in western Europe is well below population replacement levels, and it is estimated that by 2050, the percentage of Europeans who are older than 65 will rise from about 16 percent to more than a quarter of the population. Developing cheaper—but no less effective—ways of caring for the elderly, short of costly institutionalization, is imperative for health care leaders throughout Europe. In addition, as in other parts of the world where people are living longer, European health care providers must determine how to direct resources towards the prevention and treatment of chronic illness.

Dr. Frank Christ: “Today’s patient is an articulate consumer of health care services, proactively analyzing the provider landscape and looking for the right fit.”

The patients are not only, on average, getting older—they’re getting wiser as well. More informed than ever before, patients are in a position to influence the care they receive, whether this means demanding the latest treatment for a given condition, or shopping around for another health care provider. In countries where the public health care system no longer enjoys a complete monopoly, patients have been transformed into demanding consumers embracing freedom of choice. “Today’s patient is an articulate consumer of health care services, proactively analyzing the provider landscape and looking for the right fit,” said Dr. Frank Christ of LMU, who is one of the course leaders. “They are growing less tolerant of long waiting lists, inadequate information about their options, and lack of ability to direct their own care, and providers who address these concerns will position themselves for market leadership.”

Traditions and change
In attempting to evolve their health care systems, European governments have struggled to preserve their traditional commitment to equity and solidarity, while at the same time controlling costs. The government-sponsored health care system that ruled for most of the last century is gradually giving way to a new competitive health care marketplace characterized by public-private cooperation, diverse provider networks, and increased consumer power. In Sweden, for example, a country with a deep commitment to the welfare state, this trend is taking hold, and health care leaders from the UK, Germany, the Netherlands, and Norway are watching closely to see what they can learn.

Dr. Tom Aretz: “Tradition and history are often the biggest obstacles facing reformers, not only in health care, but in any industry.”

As Dr. Tom Aretz, HMI vice president for medical education and one of the course’s organizers, observes, changing health care is not just about changing the system, but also about overcoming long-held beliefs and creating a climate that welcomes new ones. “Tradition and history are often the biggest obstacles facing reformers, not only in health care, but in any industry,” he said. “The changes that have already begun to unfold, such as the growing influence of private health care providers, reflect a view on the part of leadership that quality health care and higher patient expectations for it are closely tied to economic competitiveness.”

Prof. Klaus Peter, dean of the medical faculty of LMU and co-initiator of the course concept, said, “Providers of tertiary and complex care which traditionally have included academic medical centers must form alliances and networks to provide seamless access to all levels of care for their patients, and allow for medical education and research across the whole spectrum of health care—a huge task given the realities of today’s marketplace and regulatory environment.”

For more information about the Executive Leadership Course for Health Care Professionals, or to apply, visit the course website. There is a reduced fee for those who apply by May 17th.