Dr. M, heavily recruited out of med school, begins her career enthusiastic about the healthcare system that has hired her. Like many of her generation, she is uninterested in the business of running her own practice and feels she can better serve the community as part of an established healthcare organization.
Dr. K spent the better part of a decade managing a private practice with his partners. The stress of running a business at times took away from what he sees as his primary purpose–helping patients. For this reason, he was open to and eventually excited about the opportunity to be acquired by a large healthcare system.
However, in the months and years that follow, both Dr. M and Dr. K feel less enthusiastic about their employers. They see the expectations placed on physicians as unrealistic, and yet, physician concerns go unheard. Dr. M’s supervisor regularly cancels or postpones their scheduled check-ins, and when those meetings do take place, she feels merely placated. Patients see Dr. K as the face of his organization, and yet, he has no real authority or autonomy to make decisions. Other physicians feel similarly, and as a result, the work environment has become unhealthy. What can be done?
Hospital administrators know all too well the importance of physician engagement. Study after study confirms its significance, and yet, a troubling disconnect undoubtedly exists between physicians and the organizations that employ them. This disconnect, or lack of engagement, can lead to physician burnout and turnover, which ultimately, have a negative impact on both patient care and revenue.
In the fall of 2020, Jackson Physician Search conducted a survey of physicians and administrators to understand their current views on physician retention, and specifically, how lack of engagement, burnout, and now, COVID-19 contribute to the problem. The findings, reported in the White Paper: On the Verge of a Physician Turnover Epidemic, suggest little has changed in recent years. In the Physician Retention Survey Results, nearly seven in ten physicians rated themselves as actively disengaged with their employer. Meanwhile, only 35% of administrators rated their physicians as actively disengaged.
Further questions about meetings at the organization, leadership training, and recognition programs shed light on the methods used to address physician engagement and how those efforts are perceived. Improving physician engagement will certainly require a multi-faceted approach, however, the single most important step may be enhancing communication.
Why Communication Is the Key to Physician Engagement
When the C-suite thinks about improving communication with physicians, the first question is likely, “How can we better communicate our mission and objectives to our physicians?” However, the more appropriate question is, “How can we better listen to our physicians?” or “How can we make our physicians feel heard?”
If physician engagement is low (and the data suggests it most certainly is), leaders must first ask questions and listen to their physicians in order to understand what factors are contributing to the problem. Solutions won’t likely be immediately obvious, however, asking the right questions and encouraging physicians to speak freely may be half the battle.
A 2019 article in the Journal of Healthcare Leadership examined the antecedents of physician engagement, and “communication” was near the top of the list. The article cites multiple components of an effective communication strategy, including two-way communication, transparency, non-judgmental feedback, and data sharing. Administrators can adopt these tactics by focusing on the following four actions.
Talk to Physicians
Though it may seem obvious, the most effective way to improve communication with physicians is to talk to them–and it’s worth adding–to encourage them to talk to you. Effective two-way communication means making time for meetings. Physicians should not only have regular check-ins with their supervisors, they should also attend periodic one-on-one meetings with key leaders. In the Jackson Physician Search Study, only half of physicians and administrators report consistent meetings between physicians and supervisors or other key leaders.
Of course, when “overworked” is at the top of the list of physicians’ problems, finding the time for meetings is an issue all its own. However, making time becomes easier when the positive impact of these meetings is clear. Ask physicians to provide a rating after each meeting to measure its effectiveness and adjust if the value is not apparent.
It’s important to note that formal meetings are not the only means of talking to physicians. In order to understand the challenges they face, administrators should develop multiple feedback channels including surveys and online forums. Leaders should make time to occasionally round with physicians or attend a pre-shift huddle. Take a physician to lunch or coffee. The insight they provide could be invaluable, and the encounter will go a long way toward increasing engagement.
When talking with physicians, they must feel comfortable to speak freely about the problems as they see them. Issues should be acknowledged without judgement. Leadership has an opportunity to express empathy and support. Physicians may be asked to consider potential solutions and invited to present them at a future meeting. From there, they can collaborate on the best path forward.
Just as you encourage honesty from physicians, you must be honest with them. Organizational transparency is critical in any workplace culture, and this is especially true with physicians. They are highly educated, critical thinkers who often need to understand the big picture in order to buy into a policy. Share the data driving new policies and be clear about the reasons for requested actions. Physicians are more likely to embrace a change when they understand its significance.
Invite Participation and Solutions
To further conversations and promote transparency, leadership should invite physicians to be a part of the decision-making process. While not every physician at the organization can have a seat at the table, their voices should be represented by a physician leader who listens to his or her peers and is willing to convey their thoughts and concerns to leadership.
However, physician representation should bring more to the conversation than complaints and observations. Invite physician leaders to be proactive in finding solutions. This might involve forming a committee of physicians willing to collaborate and solve problems. Schedule time for leadership to hear the ideas–but only if they are truly open to considering a new process or solution.
The impact of placing physicians in leadership roles goes beyond increasing engagement. As described in a 2019 article for Healthcare Management Review, hospitals with physicians in leadership and management positions received higher quality scores than those without physician leaders. The correlation is not surprising for a variety of reasons, one of which is the known impact of physician engagement on the quality of care. If physician leadership increases engagement, one would expect quality scores to increase under physician leadership.
Measure and Share Results
Effective communication doesn’t end with a survey or suggestion box. As discussed, healthcare leaders must listen to physicians in order to understand their challenges, but the goal of these conversations should be to identify potential solutions. Not every idea will be successful, so it’s critical that the impact of the change is measured and shared with physicians.
Where the data shows a positive impact, leadership should strive to scale the solution. Where the data does not support the change, they can adjust the course of action. Even when a new process does not prove effective, the willingness to change the status quo demonstrates that leadership is listening and taking steps to address concerns.
Increasing physician engagement requires a multifaceted approach. However, before the issue can be fully addressed, administrators must consider the status of communication at their organization. If they don’t have multiple channels for listening to physician feedback, they cannot begin to address the reasons for a lack of engagement.
Fortunately, improving communication begins with the series of simple actions outlined here: talk to physicians, encourage honesty, invite participation, and measure and share results. Leaders can also address the issue on the front end by hiring physicians with excellent communication skills who fit the culture of transparency.
The Jackson Physician Search recruitment team excels at helping healthcare organizations recruit and retain physicians who are a good fit both clinically and culturally. Contact us today to learn more.