Dr. L was sitting down with his supervisor for the first time in four months. What was supposed to be a monthly one-on-one meeting had been rescheduled multiple times, but they finally found a time that worked for both of them. Dr. L was hoping to address several issues, and yet, he found himself holding his tongue as his manager outlined the various ways physicians would need to continue to “step up” for their patients and the practice. Dr. L wanted to take care of his patients, but he also knew his current workload was unsustainable. He thought this meeting, which he had waited months for, would be the right time to address the problem, and yet, it was clear his supervisor was not ready to hear it.
Dr. L’s supervisor isn’t cruel or oblivious. He can likely sense that Dr. L is feeling overworked, however, he prefers to avoid discussing the issue altogether rather than listen and have to explain that there are no easy solutions to the problem. What the supervisor doesn’t understand is that while those broader solutions are desperately needed, the first step toward easing Dr. L’s troubles is creating an atmosphere of trust where he can communicate his concerns and feel confident that leadership is working towards solutions.
Physicians Prioritize Communication with Management
Overall, healthcare leaders are indeed working to find solutions to problems big and small. In August of 2022, Jackson Physician Search and MGMA conducted a study to understand what steps medical groups are taking to improve physician recruitment, engagement, retention, and burnout. The resulting whitepaper, Back from Burnout: Confronting the Post-Pandemic Physician Turnover Crisis, documents the results.
One notable finding of the joint study is the ongoing importance physicians place on two-way communication with management. For the second year in a row, physicians ranked this the most important factor in job satisfaction—above compensation. In fact, 85% of physicians said two-way communication with management was “very” or “somewhat important” to their job satisfaction. However, when asked to rate their employers in this area, just one in four said two-way communication at their organization was “good” or “very good.”
The Relationship Between Trust and Communication
Open communication with management is critical to a physician’s job satisfaction, and currently, most organizations aren’t meeting expectations in this area. Healthcare leaders must create an atmosphere of trust and transparency if they hope to improve communication with physicians and increase job satisfaction.
Unfortunately, trust in leadership is low among physicians. According to a survey commissioned by the American Board of Internal Medicine Foundation, in 2021, 30% of physicians reported they do not trust their healthcare organizations’ leadership. Another 17% said they neither trust nor distrust their employer. What’s more, one-third of physicians said they lost trust in the healthcare system as a whole during the pandemic.
This lack of trust is crippling communication between physicians and leadership, but it is detrimental to other aspects of the organization as well. According to research from Gallup, across industries, one in three employees would stay with their employer longer if leaders kept their promises, and when trust is high, organizations have 50% higher employee productivity. When employees trust their employer, 74% experience less stress and 40% report less burnout. Additionally, 96% of engaged employees trust management compared to 46% of disengaged employees.
So it seems, trust is not only the key to improving physician communication, but trust is also critical for improving engagement, retention, and burnout. Thus, establishing a foundation of trust has never been more important in healthcare organizations.
How to Build Trust and Foster Communication with Physicians
How do you know if communication and trust are areas of concern at your organization? The first step is to evaluate the current level of perceived transparency among physicians and staff. A survey may be useful in gathering data, however, one-on-one conversations will provide more qualitative information. Pay attention to what’s not being said as well. In the meeting described above, Dr. L sat silent while his supervisor talked. Dr. L didn’t feel psychologically safe enough to speak frankly, and yet, his silence was the only indicator of this lack of trust. Is this happening in your meetings? Ask yourself other questions as well, such as: “When was the last time a physician came to me for help?” and “How often do I sit down one on one with physicians?” and “Who does most of the talking in my conversations with physicians?”
Regardless of your answers, there is likely room for improvement. In the blog post, 4 Ways to Improve Communication and Increase Physician Engagement, we discuss the importance of talking to physicians, encouraging honesty, inviting participation and solutions, and measuring results. However, all of this requires a foundation of trust. The new JPS and MGMA whitepaper details five aspects of building “psychological safety” in your organization. Keep reading for an introduction to creating an atmosphere of trust that fosters communication.
- Be accessible — Most organizations recognize the need for regular one-on-one meetings between physicians and leadership, but as was the case for Dr. L in the above scenario, those meetings are often the first to be rescheduled when conflicts arise. In addition to scheduled meetings, make yourself available in a more casual setting. Walk the hallways, get coffee in the break room, and otherwise create opportunities for physicians to approach you.
- Invite participation — When the meetings do occur, make sure communication goes both ways. Ask the physician to bring a list of items to discuss and start with those before getting to your agenda. If the physician brings up a problem, encourage them to bring several potential solutions to the next meeting. Don’t wait for formal, one-on-one meetings to ask for input, make it a habit to ask open-ended questions and spend more time listening.
- Display fallibility — Sometimes leadership implements policies or systems that don’t work. Occasionally, problems arise that aren’t handled well. Be able to admit when you’ve made a wrong turn and specify how you plan to correct the course. It’s much easier to forgive mistakes when the offender accepts culpability.
- Fail forward — In addition to admitting your mistakes, learn from them. If you’re running into resistance on the new physician wellness program, figure out why. Perhaps you’ll discover that in-house yoga and a mental health hotline are not what physicians actually want or need to mitigate physician burnout. Accept the mistake and vow to listen more and discover what exactly they do want.
- Set clear expectations — In your conversations with physicians, work together to set clear expectations and boundaries, and be prepared to hold people (including yourself) accountable. Physicians need to know that leadership notices when someone disregards the rules and there are consequences for transgressions.
Of course, building trust takes time. Begin with scheduling and attending regular one-on-one meetings with your physicians. Encourage them to participate and listen to what they have to say with an open mind. Ask for solutions, and if possible, agree to try them. Acknowledge your mistakes and learn from them. Set clear boundaries and expectations for yourself and others, and then hold people accountable.
Focusing on these things will help you build trust within the organization and ultimately improve communication between physicians and management. By doing this, you will address a core need resulting in improved physician engagement, retention, and recruitment.
If your organization is struggling to retain and recruit physicians, building an atmosphere of trust is a critical first step, but you’ll also need the advice and counsel of a national physician recruitment firm like Jackson Physician Search. Contact us today.