Physician Engagement


Strategic Alignment


physician-organization compacts

The Physician Organization Compact

A NEW COMPACT: Aligning Physician Organization Expectations to Transform Patient Care

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Accelerating Change & Improvement in Healthcare

Amicus works with health care organizations to build change capacity through physician alignment and engagement. We believe care improvement requires trust and collaboration among doctors and between doctors and their organization. Strained or frayed relationships are impediments to moving forward together that need to be, and can be, addressed.



Jack Silversin DMD, DrPH and Mary Jane Kornacki, MS
are the founding partners of Amicus.

Jack Silversin DMD, DrPH

A graduate of the Harvard University School of Dental Medicine, Jack Silversin holds a doctorate in public health from Harvard University and serves as a member of the faculty of medicine in the School of Dental Medicine. He is a nationally recognized speaker on physicians and change and a regular presenter at IHI conferences, faculty for Medical Group Management Association-sponsored executiveeducation programs, and content expert for Minneapolis-based ICSI’s collaborative on building a culture of quality.

Mary Jane Kornacki, MS

Mary Jane Kornacki holds a master of science degree in public health from the University of Massachusetts, where she specialized in health education and health behavior. Her special interests include leadership, team dynamics and the professional satisfaction of women physicians in medical organizations. Her understanding of the principles of adult learning and behavior change are reflected in the models and tools that are fundamental to Amicus’ consulting work. Jack and Mary Jane have collaborated on numerous publications on physician cultures, physician morale, medical group dynamics, governance in physician organizations and service improvement in health care.

How We Help

Consulting Services

  • Physician alignment and engagement through creation of a physician-organization compact
  • Effective mergers and affiliation from a cultural perspective
  • Mending and strengthening trust to support collaboration and care coordination across parts of an enterprise or across organizations
  • Leadership and governance development
  • Shared vision and translation into strategy
  • Implementation of large-scale change


Jack Silversin offers presentations for executives, senior leaders, physician leaders and medical staff. His talks are bespoke and reflect client’s unique needs and situation.

He has spoken on a range of topics related to healthcare culture, physician leadership challenges and physician-organization engagement. He has given keynote talks to kick-off retreats and conducted workshops related to the physician-organization compact.

To learn more about topics and fees, contact Amicus at 617.354.7983 or write to Jack at jack@consultamicus.net


All members of an organization have implicit expectations of the deal they signed onto. These unwritten, but no less significant, expectations are a compact. As the pace of health care change has quickened, many physicians are feeling frustrated. Many are asked to innovate and adopt changes that feel outside of their original deal. Exploring the traditional compact and how it does and doesn’t fit with evolving organizational needs has proved to be a useful way to engage physicians toward the aim of improving professional satisfaction and alignment with strategic aims.

Compact Checklist

The process of developing an explicit compact is facilitated when the following conditions are in place:

  • Sufficient trust between doctors and administrators to be able to have candid conversations
  • Education for doctors about market and economic changes that are driving the need to change the way health care is delivered
  • Wide and deep ownership of a shared vision – a picture of where the organisation is heading – that resonates with all
  • A guiding coalition or committee that can champion a compact change process with the physician body
  • Sufficient patience to allow a process that touches every doctor – NOT a “roll out” from senior leaders
  • Ample time for doctors and administrators to engage in dialogue about what behaviors are needed
  • Will from the top to hold both administrators and physicians accountable for living the compact commitments once a document is created that is broadly supported
  • Top leaders demonstrate they are NOT exempt but are standard bearers for new behaviors and open themselves to feedback about how their behaviors are or are not consistent with the new compact


Upcoming Presentations

Mary Jane Kornacki and Jack Silversin:
The Medical Guild and Evolving Challenges of Healthcare Delivery

Durham University (England)
Wednesday, February 15, 2017

Jack Silversin and Gary Kaplan:
International Forum on Quality and Safety in Healthcare, London, England

London, England
Tuesday, April 25, 2017
Workshop: Engaging healthcare professionals to transform care

Past Presentations

International Forum on Quality and Safety in Healthcare

Gothenburg, Sweden
Thursday, April 14, 2016
Workshop: Engaging Clinicians for Transformational Change: Lessons from Virginia Mason Medical Center
Workshop: Aligning Management And Doctors To Transform Care Delivery: A New Model

IHI International Summit on Improving Patient Care in the Office Practice & Community

March 22, 2016
Workshop: Tactics to Engage Physicians

Jack Silversin with Gary Kaplan, MD CEO and Chair, Virginia Mason Medical Center, Seattle, WA

Minicourse: Engaging Physician in Care Transformation IHI National Forum on Quality Improvement in Healthcare 2013, 2012, 2011, 2010, 2009

Physicians and Hospitals Together: Yes we can! Engaging Physicians in Care Improvement Executive Seminar for Dutch Healthcare Executives Zorgvisie Magazine Reed Business Media Houten, The Netherlands, January 2014, October 2012

How Do We Build Physician Leadership And Engagement to Support Patient Safety? Patient Safety Congress 2012 (UK): May 2012

Engaging Doctors in Care Improvement: Why and How International Forum on Quality and Safety in Healthcare [BMJ and IHI sponsored] Amsterdam 2011,  Paris 2012, London 2013, Paris, 2014

Jack Silversin with Gregory Long, MD CMO ThedaCare

Minicourse: Engaging Physicians in Transforming Care IHI International Summit on Improving Patient Care in the Office Practice & Community 2012, 2011 and 2010

Other IHI presentations by Jack Silversin

Workshop: Engaging Physicians: Insights and Actions for Results IHI National Forum on Quality Improvement in Healthcare 2011, 2019, 2009

Workshop: Tactics to Strengthen Physician Engagement IHI International Summit on Improving Patient Care in the Office Practice & Community 2012, 2011 and 2010

For the VHA in 2012

VHA Upper Midwest Board and Executive Meeting: Engaging Physicians to Transform Care

VHA Upper Midwest Physician Preference Meeting: Engaging Physicians in Transforming Care

Northeast Purchasing Coalition Semiannual Meeting: Committing with Physicians for Mutual Benefit

VHA Supply Networks Executive Summit: Engage Physicians to Achieve Breakthrough Results

Presentations to Medical Staffs, Chiefs, Leaders and Future Leaders

Hennepin County Medical Center

University of Kansas

UMass Memorial Medical Center Physician Leadership Development Program

Crystal Run Health Care (New York) Physician Leadership Development

Baystate Health Care (Springfield, MA) Physician Leadership Academy



NEJM Catalyst (December 2016)
ThedaCare Cardiovascular Care: Using a Compact Reboot as Fix for a Practice That Has “Merged, Not Integrated”

NEJM Catalyst (September 2016)
Three Starting Points for Physician Leadership

American Academy of Family Physicians (January 2003)
Implementing Change: From Ideas to Reality

National Center for Biotechnology Information (April 2002)
Unhappy doctors: what are the causes and what can be done?


Jack Silversin
Mary Jane Kornacki

103 Avon Hill Street
Cambridge, Massachusetts 02140




Jack: Jack@consultamicus.net
Mary Jane: Maryjane@consultamicus.net