When it comes to big organizational changes, consulting with physician leaders is a critical factor for short-term and long-term success. “I have seen physician engagement serve as an essential ingredient for any major initiative that’s being developed and ultimately implemented by a health system,” says Medical Advantage Executive Consultant Monty Pate, our guest for this episode.
Every decision is consequential to the success of a health system. When project managers or private equity firms move ahead without input from physician leaders, they lack key information to make the best-informed decisions. Enlisting physician leadership is a beneficial change agent for the direction of major change.
When should you approach physicians for insights? Which physicians should you approach and how should you approach them? In this episode of the Medical Advantage Podcast hosted by Technology Consultant Celina DeFigueiredo-Dusseau, we answer all these questions and provide guidance on how to navigate this invaluable relationship with physician leadership.
Monty Pate covers the intricacies and best practices regarding this cooperative relationship, plus real-world examples of the effectiveness of physician leadership.
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Key Takeaways from Podcast Episode 33 Recruiting Physician Leadership for Health System Success
What Physician Engagement Is
Physician engagement involves a “physician champion” who provides influential insight and serves as a voice in the interests of his or her peers. This is a partnership role for the development and rollout of initiatives – particularly transformational projects.
This can include a wide variety of undertakings; anything from new EHR implementation, construction projects, compensation models, consulting or private equity engagement, patient workflow, and even provider recruitment.
The Role of a Physician Champion in Modern Healthcare
Physician engagement serves as an essential ingredient for any major initiative being developed with the end result of being implemented by a health system. Essentially, the role of a physician champion is a change agent that can create momentum and bring about a cultural alignment to support the initiative.
What Health Systems Should Look for in a Physician Champion
Ideally, when seeking a physician to engage, you’re looking for providers who have a broader understanding and appreciation for all the elements that make up the healthcare enterprise. To be effective in this role, the physician should have a firm understanding of budget, staffing, patient engagement, brand loyalty, informatics, compensation models, quality, telehealth, etc. This role is best for a physician with a global perspective with regard to healthcare.
Aside from experience, this role is best suited for someone willing to be part of the solution and work with other stakeholders in a truly collegial and collaborative manner. This can manifest either by being part of committees or working groups. This physician should be willing to provide input that is frank, honest, and constructive. At the same time, he or she represents the overall best interests of the health system.
Finally, you want to find physicians who can garner buy-in. This means the physician is well respected amongst their peers, but also is willing to communicate at the peer-to-peer level to introduce the strategies and initiatives being developed. It is also beneficial to engage with providers from diverse practices, i.e., primary care and specialty care.
Why Physician Engagement is a Unique Leadership Opportunity
Because providers are so closely involved with the delivery of care, they bring a unique perspective as to the initiative’s impact down to the patient level. Also, a provider advocate or champion can really bring credibility to the project. It’s one thing for C-Suite or administration to talk about initiatives or plans, but to have a physician champion who is aligned and supportive of those plans only helps to align the organization in the long run.
By their nature and training, providers want to understand the “why” behind any given project, and this is another benefit because consultants and administration must then articulate the “why” behind what they’re doing. Another aspect to consider – and sometimes this can be a little painful on the front end – is that by their training, providers will look to challenge gaps in logic. They challenge assumptions, which really forces the stakeholder to reconcile these concerns early in the process and that is ultimately a positive thing.
On the flip side of this, if you fail to engage your providers, this may generate a rumor mill within the organization if they’re not sure what’s occurring or why it’s occurring. This is just human nature to have a fear of the unknown. It also can erode morale when input from physician champions isn’t called upon for consideration. Providers as a group also want to be heard and they want to know that their input matters. When you neglect to engage your providers, you’re really missing out on that critical provider perspective.
Where to Begin in Developing a Physician Engagement Strategy
Start with the C-Suite; CEO and COO. Your C-Suite should know which providers are collaborative by nature, as well as the ones that see the big picture of healthcare enterprises.
The folks in the front office should know their provider team and know not only who the formal leaders are within the organization, but also the informal leaders. Informal leaders may not have a formal title, but they are the ones whom the other providers and staff look to.
Finally, you want to leverage that C-Suite knowledge in terms of identifying providers who want to be part of the solution. What you really need are providers who – rather than just criticize – will roll up their sleeves, be a part of the solution, and come along on the journey. Begin these discussions at the conceptual stages of any initiative so it is done early on to assess a willingness to participate.
Real Example of How Physician Engagement Fostered a Positive Outcome
The leadership for a health system in the south – that is part of a large hospitalist group – was looking for a way to incentivize hospitalists to support the system’s quality goals. The administration communicated the “why,” which is to move the needle on the quality outcomes. The reason being the administration realized that hospitalists have a great impact on inpatient quality.
They were also looking to create a physician compensation model and bonus structure. The idea was to tie such incentives to quality metrics that aligned with the system’s quality initiatives. The intent was to create a win-win, a win for the providers and a win for the system.
The hospital leaders received the directives in a very well-laid-out, articulated way. The first thing that the hospitalist leadership did was to solicit input from all the providers on their team. This consisted of a group of about 80 or so hospitalists spread out over 4 different campuses. Then the hospitalist and the physician leadership partnership worked with the administration to develop goals that were aligned with the system’s quality goals. They were also given the opportunity to see bonus payments based on quality outcomes.
However, the goals being developed needed to be realistic advancements in quality metrics, not gimmies. They needed to be measurable – based on valid and timely data – and be aligned with the system’s objectives to bring value to the system. This was an organization – like all healthcare organizations to some degree – looking to reduce length of stay, reduce unnecessary emergency department (ED) visits, lower readmission rates, etc. With several of these goals in mind, the team selected a leader for each aim, and this leader helped develop action plans to see it through.
This entire process was very transparent. The hospital and administration were able to utilize dashboard reporting on a continual basis. Such reporting tracked outcomes in terms of quality, and the impact on the system. This ultimately confirmed the result as a win-win for everybody. Bottom line, there was a highly engaged provider group aligned and supportive of the health systems quality initiatives.
Real Example of What Can Happen When Physicians are Not Engaged
It is so important to engage physicians in initiatives early on – even for construction plans. To skip this step can lead to costly oversights. For example, a facility construction project for a very large multi-specialty practice was underway. The initial stakeholders in the project are who you might expect; administration, architects, engineers, and procurement. All stakeholders on the team were very intelligent and highly capable.
Partway through the construction of the facility, someone suggests, “Maybe we should have the providers – the people who will be working in this building – look at the progress. Maybe we need to get their input.” The construction was about 50% completed at this point. From the providers’ feedback, the design was found to be less than optimal for the providers. Flaws were pointed out with sink location, patient flow, and the workstation’s design and location. Electrical outlets could have had better placement as well.
Getting physician feedback well before you break ground can help you avoid unfortunate missteps. Anyone who has been involved in construction knows that change orders create delays in the project and are also expensive. This served as a lesson to gather physician input in the beginning when plans are being drafted.
Physician engagement is a critical factor for any major initiative within a health system, It can help create momentum, generate buy-in and the cultural alignment needed to ensure a successful outcome. It is also crucial to know which providers are the formal and informal leaders within the organization.
Coming in as an outside consultant, it is important to engage not only with your C-Suite but also to – whenever possible – loop in those operation managers at the practice level. This uncovers who the true influencers are amongst your provider team.
You need to engage these champions early on at the conceptual stage of any initiative. You need to be prepared to explain the why behind what’s taking place. The more you clearly articulate to the provider team what you’re doing and what the rationale is behind it, the better. Finally, emphasize that – to be successful in this initiative – the physician champion must be part of the solution.