And almost without fail, the talk is about what doctors need to do to engage. Clearly, from the health system’s point of view, it’s all about what doctors are not doing.
To me, that feels rather one-sided. Instead, how about creating a positive environment where hospitals and physicians can work together for mutual growth? After all, engagement is a two-way street.
A valuable piece of advice for healthcare organizations acquiring physicians: get introspective.
Ask, what's in it for the physicians? What would they get out of a closer, more bonded relationship with us, the hospital? How should this new relationship be tailored so that it feels win-win to them? What do we have to offer that can be of value to the physicians?
I guarantee, hospital leaders will have quicker and less volatile discussions if they truly get deeper into these questions and take action on implementing the answers. Without seeing both sides, they risk missing out on dynamic, mutually-beneficial collaborations with their physicians.
Consider these key factors when looking for the best ways for hospitals and physicians to engage:
1) Do your homework. Take the time to do some prior work and come up with a time frame for absorbing a physician’s practice. Ask what this new business model will mean for the physician. Does he or she have anything at risk if they more fully engage? Whom do they trust within the organization to be their guides and advisors? Does engagement always mean a business process or could it purely be a relationship process?
2) You have to engage them in the process or they won't buy the outcome. Physicians are very smart people but not necessarily good business people. What might be the right decision from a business perspective isn't always right for a particular medical practice.
3) It's personal, not business. Sometimes the next step in physician engagement is employment. Doctors have spent years, maybe their whole careers, building up their practice. Selling it to a hospital or other healthcare organization can be as much a personal decision as a business one. And keep in mind, they may not be happy about the sale. From the relationships they have established with their patients to their name on the door, their practice is personal to them.
4) Loss of control. I hear this almost every week from doctors. They have spent the better part of their careers envisioning where they thought they were going to be, and now everything’s changing and they can't control it. Some are happy to be more aligned or owned—it’s a relief to have someone who wants to purchase their practice because it frees them from the challenges and hassles of the business side of medicine. Similarly, many doctors fresh out of residency are happy to be employed by a hospital and aren’t interested in hanging out their shingle. But most are unhappy about it. Their vision has had to change, and it’s not happening with a lot of glee and glow—this is really hard for them.
5) When hospital leaders talk about physician engagement, they tend to state everything on their terms. Instead of entering into a dialogue with physicians, they typically say, “Here are three or four ways we could engage with you in the near term. What role do you want to play?” As opposed to, “What can we as a hospital offer you? How can we successfully partner with you in this transition? How do you envision our relationship, and how can we work together to get there?” All it takes for true engagement is for those in leadership to take the time to understand where a physician is coming from. Likewise, physicians need to be forthcoming with their expectations and what they bring to the table.
It is not about rational interests or financial rewards. It is about pride and emotions and dignity. And the realization that change is hard, and often painful.
Successful, mutually-beneficial physician engagement is not a pipe dream; it can happen, and it does happen, in many, many organizations. But it takes deep understanding from each side to see where the other is coming from—what are their goals, expectations and misgivings.
When physician engagement is done right, as a true collaboration, patients ultimately come out the winners.