The health care industry is undergoing a time of turmoil and transformation. Health care providers must address ways to improve health care outcomes, reduce waste and variations in care, lower operating costs, embrace new payment models, adopt new technologies, acquire new capabilities, and face an increasingly critical public eye on safety. In order to successfully make these transitions, strong physician engagement and leadership is a requisite, yet many systems struggle to implement a successful physician engagement strategy. Without an effective strategy, little will fundamentally change.
Given the traditional differences in culture and organizational and payment structures, hospital-physician collaboration is operationally complex. Research shows that a lack of physician engagement translates to poor clinical management, negatively impacts quality of care, increases medical errors, and contributes to higher health care costs. Challenges around development do exist. Physicians are schooled to be autonomous decision-makers and often lack training in leadership, organizational management, teamwork and systems thinking. Individualism and the desire for personal control can make it difficult to weave physicians into an integrated organization or develop consensus. Like any organization, the majority of physicians are neither actively engaged nor actively disengaged and are “up for grabs.”
Physicians need to trust the infrastructure that will drive the mission of quality patient care that they have dedicated their careers to and any metrics are meaningful to this mission. As physicians are trained through an apprenticeship model, both the message and the messenger are important to them. Without engaged physician leadership to drive the collaborative approach, transformation simply won’t happen.
The statistics on the link between hospital-physician collaboration are revealing:
- Only 36 percent of practicing physicians believe they have a major responsibility for reducing health care costs (JAMA)
- Physician practice variation accounts for almost one third of wasted costs in health care (Institute of Medicine, 2011)
- Organizations with high physician engagement demonstrate higher productivity and profitability (Gallup)
A solid physician engagement strategy lays the foundation for current and long-term change that drives better patient-centered quality care and outcomes and lower costs across settings. Physicians must acquire new capabilities and competencies but health care systems need physician champions to accelerate and drive the adoption of best practices, collaboration and enabling technologies. Physician champions will encourage other physicians who are unsure if they want to participate.
A strategy centered on physician-led transformation establishes a foundation for the development and of shared physician and organizational goals. Physicians should be included in the process to shape the vision rather than having it shaped for them. It creates a strong culture of ownership, teamwork, and accountability that allows for the accomplishment of shared goals. Physician behavior drives quality measures, care delivery, patient experience and outcomes, and creates health care value. Health care systems must guide and support physicians by implementing a methodology that focuses on three phases: 1) Envision 2) Empower 3) Extend.
Jointly identify the strategic needs of the organization and develop shared vision and goals between the organization and physicians as well as the clear rationale for change. Additionally, create the migration path by clearly defining the changes needed, steps, timeframes, and milestones to achieve projected outcomes. Establishing an integrated leadership framework with strong physician leadership, representative of target physicians, will shape the path for success.
Prepare who will lead their peers in achieving these shared goals by creating formal leadership networks. These networks will provide guidance and feedback and equip all physicians with the tools, mentoring, communications, education and training needed to accomplish the goals. Medical directors, department chiefs and influential physicians play a major role in modeling change and building peer-to-peer trust. Providing objective and meaningful feedback and metrics helps physicians focus their efforts to achieve the shared goals.
Lastly, organizations can build upon these physician engagement efforts to develop a foundation for longer-term and sustainable change, and create a culture of collaboration and teamwork. Such organizational cultures improve the physician experience and satisfaction, enhance recruitment and retention and drive innovation across the enterprise.
At its core, health care still boils down to the interaction between the patient and medical provider, but the complexity of the systems has changed over time. Health care organizations have an opportunity, and responsibility, to make that moment more effective, efficient, patient-centered, and data-driven. Physician decisions and performance drives such a large part of the patient experience, utilization costs, quality outcomes and organizational change that an effective physician engagement strategy become the keystone for health care industry transformation and sustainable change.