Extending the Dyadic Management Model for the Integrated Community Health System

“Physicians who practice in the integrated models must accept that the autonomy of private practice is relinquished to the team approach. Rarely, however, do physicians in these models report that their ability to exercise professional judgments on behalf of patients is usurped by the dyadic model.
On the contrary, many perceive a new type of autonomy; an autonomy that comes with being a valued participant in the whole. Effective dyadic model leaders will encourage a culture and organizational psychology that engages physicians as participants in clinical and business decision making for the system.
Non-physician professional managers must accept that trained practitioners can be successful managers in a partnership model. At times, non-physicians are threatened by the notion that ‘if physicians can be clinicians and managers, why do organizations need me?’…
In other words, each owns the overall performance of the enterprise under them. Neither is permitted to delegate responsibility for these common areas or blame the partner for his or her lack of performance in this regard. The success of each is tied to the other.
But how are distinct and separate responsibilities and accountabilities identified, divided and managed? This is also the art in the design; while each owns areas of performance overall, day-to-day operations distills to distinct and stated responsibilities and accountabilities…
It’s important to note that no management model is 100 percent reliable or infallible…Long-term success with the dyad model does require an organizational commitment to the design, supported by a commitment to invest in the development of physicians as co-leaders and co-managers.
For successful users of the model, the dyad becomes a part of the cultural fabric of the organization; ‘it is how we do it here.’
Members of successful dyads often refer to the relationship as a marriage. ‘We don’t always agree, but we know we need to make the relationships work for the good of the organization and those we serve.'”
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