Never has physician engagement been more critical, yet few health care organizations can even define it. This may explain why the recent nationwide multispecialty survey of physicians by Physician Wellness Services and Cejka Search found, among other things, that engagement levels over the past three years have grown at a lukewarm pace, at best. (See the bar chart below.)
The survey confirmed that feeling engaged was very important to physician job satisfaction. It delved into what was important to them — and it found gaps between what they would like to experience and what they are experiencing. It also measured their current level of engagement with their organizations and their work. The survey found that all 15 elements of engagement presented to the physicians were important to them, with all scores in the top quartile on a 10-point Likert scale. (See "The 15 Elements of Physician Engagement" below.) A 10 was always the highest score, often by a wide margin.
The survey also demonstrated that engagement has a significant impact on a physician's decision to accept or leave a position, with clear implications for recruitment and retention.
Health care organizations can take actions to improve engagement — and by extension, participation and buy-in — among their physicians. At a time of growing physician shortages and competition between health systems for top physician talent, key initiatives can help organizations to reach critical goals.
The 15 Elements of Physician Engagement1. Respect for my competency and skills
2. Feeling that my opinions and ideas are valued
3. Good relationships with my physician colleagues
4. Good work/life balance
5. A voice in how my time is structured and used
6. Fair compensation for my work
7. Good relationships with non-physician clinical staff
8. A broader sense of meaning in my work over and above my day-to-day duties
9. A voice in clinical operations and processes
10. Opportunities to expand my clinical skills and learn new skills
11. Opportunities for professional development and career advancement
12. Good relationships with administrators
13. Alignment with my organization’s mission and goals
14. Working for an organization that is a leader in innovation and patient care
15. Participation in setting broader organizational goals and strategies
Note: These elements are listed from highest to lowest, in order of absolute scores in response to the question, “What is important to feeling engaged?
Three Steps for Improving Engagement
What can health care organizations do to build engagement with their physician population?
1. Begin by checking the pulse of your physicians' engagement. Ask them how engaged they're feeling — and what the drivers of engagement are for them. An online, anonymous survey is ideal, as it's more likely to get a higher level of participation.
Dig into specifics. Try to learn as much as possible about what physicians find the most important — and where they see gaps between what they would like and what they are experiencing.
2. Share the results of the survey in ways that encourage discussion and interaction. Such sharing is critical — nothing will speak louder about an organization's commitment to engagement than airing the results and listening to physician reactions. If possible, recruit a physician to serve as a thought leader who can guide the process and encourage participation.
3. Once there is clarity on what makes physicians feel engaged, develop a road map of what needs to change, then communicate and act on it. Make the plan as tangible as possible, and provide resources to support those who are affected. As tempting as it may be to focus on administrators' goals and initiatives, resist the urge. Pressing an agenda that focuses exclusively on administrative goals may be counterproductive and undermine efforts to foster engagement.
While some changes may fit within existing organizational and clinical frameworks, leaders may need help to create resources to address physician engagement. For example, developing a sabbatical program so physicians can go on medical missions or receive advanced training or education, would address their desire to find broader meaning in the work they do, as well as their desire for professional development.
Similarly, achieving better work-life balance — a top element that is especially critical to younger physicians — also tackles the stress and burnout so many physicians are feeling (as we found in our 2011 survey on the subject). Solutions can include more flexible hours and call programs, job sharing and more part-time opportunities, and strong wellness programs. Such initiatives can be especially compelling recruitment and retention tools — and, if designed correctly, can be cost- or revenue-neutral.
Best Practices for Physician Engagement
Regardless of how your organization chooses to proceed with physician engagement initiatives, several underlying basics are critical to lasting success:
- Ensure that physicians are involved in decision-making at every step and, if possible, leading key initiatives and activities.
- Train both physicians and senior administrators how to identify and address any barriers to improving engagement.
- Ensure that there are clear benchmarks and accountability for each initiative — everyone should know who is responsible, time frames and how progress or success will be measured.
- Measure progress periodically and adjust tactics, as needed. Communicate results honestly and constructively.
- Introduce the principles of engagement at the earliest stages in recruitment and onboarding activities.
Organizations with highly disengaged physicians may want to bring in objective, outside parties to help launch their engagement initiatives. Consultants can implement programs and introduce focused resources, such as coaching programs and other interventions that will address performance and behavioral issues that could undermine even the most well-planned and well-thought-out initiatives.
The ideal is to instill passion in our physicians for their practice setting and their health system. The most successful organizations will do this. Physicians can't have passion without first having engagement. Engagement is fundamental!
The nationwide survey findings provide a leadership framework for understanding physicians' needs. With that knowledge, they can take the appropriate steps to encourage the same passion for their organizations as they have for their patients.
Daniel Whitlock, M.D., M.B.A., and Robert Stark, M.D., are consulting physicians for Physician Wellness Services in Minneapolis.