High Stakes

R-E-S-P-E-C-T, Find Out What It Means To Your Docs

What’s the best way to engage, communicate with and integrate physicians? It’s a question everyone in healthcare wants to answer.

Historically, doctors are one of the hardest constituencies to engage. And today’s environment, where health systems are reshuffling the deck to be positioned for long-term success, only intensifies this challenge. Now more than ever, you need physicians aligned with your plans for the future.

Stunningly, a recent study from athenahealth showed that just 20 percent of all physicians are actively engaged with their healthcare institution. To bring insight into the physician perspective, we sat down with Scott Nygaard, M.D., Chief Medical Officer at one of the nation’s largest public community health systems, Lee Health in Fort Myers, Fla.

Does that 20 percent figure surprise you?

Not really. I’m sad about it, but not surprised. The fact is that so many institutions just don’t know how to go about engaging their physicians. They’re taking action, of course, and they’re hopeful that what they’re doing is right but, quite often, it’s just not right.

Instead, physicians who want to be involved and engaged with the system receive mixed or unintentionally negative messages. Very often they can be left feeling that the organization is not interested in their input, which will obviously leave them feeling pretty disengaged.

What are some of the biggest mistakes health systems make when engaging and communicating with doctors?

People assume that they alone know what is best – and that’s true of both sides. Communication and development of a shared vision are critical.  Meaningful engagement is not going to come from one side or the other getting exactly what they want. It’s going to be found in the mutual respect of give and get, which can be messy, but it will unite the parties.

Also, we’ve let money be the vehicle for satisfaction. Systems have been too afraid to deal with their physicians frustrations/anger tell them only what they want to hear.  Then they use compensation to try to build the relationships, but I think, today, there’s a real limit to how far that strategy can take you.

Doctors want to be respected; to know someone is on their side, understands their challenges and wants to help them succeed in an ever more complex and challenging environment.  I believe physicians want to be part of shaping the vision for the organization. They want a seat at the table.

In your experience what are some of the biggest pain points physicians are dealing with right now?

People think EMRs are great – and I think most physicians would say that they’re happy to have access to more information – but, in terms of driving efficiency, they’re not terribly effective. Essentially, we moved from a cumbersome paper system to just creating digital paper, which isn’t that different in terms of work flow. Additionally, the EMRs place a much greater onus on the doctors. They’re the prescribers, the documenters, the orderers, the coding experts, etc. They now feel that they have to do everything as a result of the EMR.  This is playing a more important role in the trend of physician burnout.

Beyond that it’s complexity and the promulgation of new rules. Physicians just can’t keep up. Keeping up to date with the ongoing changes in medicine is already difficult. The ever increasing burden of new regulations is also contributing to burnout as physicians struggle with all of the regulatory changes.

Of course, that’s the environment we’re in at the moment. But, it’s important to understand the burden that physicians are facing and that while they’re struggling to figure out how to be successful in today’s market, they often feel set up to fail.

Does the grapevine still reign king with doctors? 

The rumor mill might often be wrong, but it’s never in doubt. It’s important, though, to think about how that happens – it’s very often born of a failure in the communication channel. Doctors are attempting to understand their situation. If there is an information vacuum left by an absence of proactive communication on the part of the system, then the rumor mill will certainly become the mechanism by which they keep up-to-date.

With better strategies of communication, however, systems can foster trust in their physicians, which is an important distinction to point out. It’s not necessary that they always agree with you, or that they hear what they want to hear. But it is important that you tell them the “what” and the “why” of what you’re doing so that they can make informed decisions about their future. Then you have to let them make their own choices.

So, what advice would you give to systems out there who want to do it right?

You have to start by listening to their issues.  I always start working with physicians by conducting “listening tours”, building a shared vision and defining the behaviors of partnership. As I mentioned before, it really is a partnership which should involve give and get from both sides in order to develop a shared vision. Neither side should come in thinking they’ve got all the answers. You have to sit down, and take the time to listen to what the other side has to say. Those conversations will create your road map for the future

And remember, if physicians are taking time, when they could be billing, to sit down and discuss vision and strategy – to help build something – they’re clearly eager to engage. People support what they help to create. If you let them help to build your facility’s vision, then you’ll see an increase in positive engagement within the organization.


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