Engaging Physicians - A Necessity for Effective Clinical Management

With the growth of physician employment, hospital leaders have learned something that’s well known to those of us who have worked in large group practices: it takes more than a paycheck to get physicians to act as part of an organization.

Physicians are professionals in the truest sense - they identify with their profession and resist influences from outside their professional. Thus, the great resentment towards CMS and hospital accreditation agencies. Yet while most physicians endorse professional society guidelines, studies show that these guidelines are not consistently adopted. Which leads one to question, how do you get physicians to “follow the leader”?

While hospital executives are expected to effectively lead people in a particular direction, most physicians resist the pull of organizational leaders, sometimes even when the leader is a physician. As physicians give up their independence to become part of healthcare organizations, organizational obligations and expectations are new experiences for them, as it is for the organizations that employ them.

Healthcare Reform is transforming organizational culture, not just operations
The fact is that healthcare is changing. Increasing emphasis on accountability and the growth of new financial models are forcing administrators to redefine the boundaries of hospitals into integrated delivery systems and alter financial modelling.  Physicians have to adopt these changes but many are also giving up their independence and having to participate in organizations that manage care delivery through process design and performance monitoring and accountability.

Making this transition will be challenging for many healthcare organizations. Historically, many hospitals have had non-cooperative relationships with their medical staff members. This doesn’t mean antagonistic, but it means non-alignment. Peaceful coexistence, however, is not an option. Reorienting from fee-for-service medicine to high reliability systems of care that place the patient, rather than the disease or anything else, at the center of decision-making and care design is a necessity for survival.

The fact is that alignment and engagement can occur. But it requires beginning a new dialogue within the redefined healthcare organization. It’s fairly obvious that dialogue must engage a broader group of stakeholders and focus on how to build the new future. While this is easy to say, it is challenging to do. Anyone who has not been down this road must be scared of the unknowns and potential for disastrous outcomes.  

The key is to appreciate the strength of medical school education in closely aligning young physicians with the professional norms and belief systems that are part of practicing medicine. As Edgar Schein, the prolific author on organizational culture, has advocated that it is harder to change a culture than to build upon its strengths.

The road to engaging physicians requires careful planning. For many hospitals, this is best led by an experienced physician executive who understands how to bridge the differences between hospitals and traditional professionals. By building a dialogue about common interests, collaboration can begin to meet the demands of healthcare reform. With insights from working with many organizations in many settings and a deep understanding of organizational culture, I can reduce the risks associated with transformational change. My project support capabilities can help you build a new platform for physician engagement that is necessary to meet the organization’s goals.

For more information, contact Cary Gutbezahl, MD at cary@leadershipclinical.com or call 513-702-5654.