Aligning physicians on the values between a practice and an academic medicine has been an engaging challenge that’s also helped Alex Vaccaro, MD, PhD, understand the best ways to get buy-in and drive meaningful change.
Dr. Vaccaro is president of Rothman Orthopaedic Institute and a professor and chair of orthopedics at Thomas Jefferson University, both in Philadelphia.
In recent months Dr. Vaccaro has made significant changes in how his physicians work together and share resources.
“The pivot that demanded the most conviction over the last year for me involved thinking about how Rothman aligns the academic mission with the operational and financial structure of a high-volume specialty practice,” Dr. Vaccaro said on an upcoming episode of “Becker’s Spine and Orthopedic Podcast.” “Historically, the two worlds ran in parallel tracks, and each had their own incentives, governance and culture … The decision to more deliberately integrate them, redirect resources towards shared research infrastructure and retool how we recruit and develop young surgeons was not popular.”
Dr. Vaccaro said aligning teams across generations required transparency when it came to the long-term threats facing academic orthopedics and independent groups. He had to make the case that both needed to survive for each other to thrive.
To gain buy-in, Dr. Vaccaro said consistency was one of the most important aspects.
“That kind of pivot was less about a single announcement and more about repeatedly showing up, explaining the rationale, and absorbing the friction into the logic of the new direction became more self-evident,” he said.
He also emphasized the value of showing early-career surgeons the “joy” of research, presentations and publishing work.
“I have to let them see the benefits of being independent, teaching, doing research, and developing that model that works for both of us.”
This move also reshaped how Dr. Vaccaro approached behavioral changes in teams and the gap between intellectual agreement and execution.
“I had assumed that if a strategic argument was sound and the data supported it, alignment would follow quickly,” he said. “What I came to realize is that conviction at the top does not translate into readiness across the organization unless you invest almost disproportionately in communication and into developing the next layer of leaders and in creating structures that make the new behavior easier than the old ones.”
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