Our experience and research within palliative care have shown that "program champions" have been successful not so much because of what they bring to the role, but what the organizational program sponsor brings to the program champion. Certainly, a multi-talented physician champion increases the chances of success, but we've found it is the tools (intellectual capital) that she/he has to work with that are the primary determinants of success. The physician starting a practice (which is essentially what the program champion will be doing) needs to have strong clinical skills and knowledge, to be sure, but will need also to create goodwill (to build solid referral patterns), establish business processes, workflow, and databases, and generate revenue to produce a sustainable program. Organizational sponsors typically don't possess this intellectual capital specific to palliative care, and so, champions often find themselves stretched to produce results with little "infrastructure". As a result, the program champion finds her/himself spending time toward "marshalling" resources, at the expense of "deploying" those resources to grow the program.
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