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As health care organizations wrestle with delivery system transformation, there's one certainty: Strong physician relations are imperative for success. Engagement is a key factor in physician satisfaction and retention. An engaged physician workforce is also linked to enhanced patient care, greater efficiency and lower costs, and improved quality and patient safety.

But achieving true physician engagement remains elusive for many health care organizations. "It's a time of unprecedented turmoil and virtually every hospital and health system is struggling with physician engagement right now," says Thomas Lee, M.D., chief medical officer for Press Ganey Associates Inc. "Physicians are not in a great mood and the vast majority of organizations are not happy places to work."

Health system transformation calls for a different level of physician engagement than before, adds Lee. "Physician engagement today means organizing care around the patient. It means working together in teams. It means embracing the bigger mission of the organization."

One challenge facing organizations is physician discontent with their chosen careers and the health care industry in general. Dwindling reimbursements and uncertainty over health reform have left many questioning their futures. "It's the responsibility of hospital executives to educate physicians and be transparent about what's happening in the industry," says T. Clifford Deveny, M.D., senior vice president of physician services and clinical integration for Catholic Health Initiatives, Englewood, Colo. The key to generating physician engagement, he says, is through extensive communication and by establishing trust. "Physicians want to have a seat at the table. They want to be included in the conversation and be part of the decision-making process," says Deveny.

To start, hospitals and health systems should assess the organization's culture and level of physician engagement to identify areas of both disconnect and consensus. Hospital executives must understand the goals and desires of the medical staff and, conversely, the medical staff must understand the goals and interests of the organization, notes William Jessee, M.D., senior vice president and senior adviser, Integrated Healthcare Strategies. This will help to align interests and create a shared vision, he says.

David Battinelli, M.D., chief medical officer for North Shore-LIJ, Great Neck, N.Y., describes it this way: "Engagement is a robust, transparent process of sharing data. We try to be as transparent as we can and share as much as we can with our physicians."

Another key driver of physician engagement is professional satisfaction. "Physicians want to feel supported in their work and they want to take pride in their work," Jessee says. "Hospitals and health systems need to make it easier for them to do a good job."

Hospitals and health systems can further enhance physician engagement by developing physician leaders within the organization. "Senior executives should create processes to grow physicians in their careers," says Joe Mazzenga, vice president, Furst Group.

Physicians need mentors within the organization who pay attention to their career paths and explain important career markers, he says.