Visit physicians where they practice to understand their business, treat them with respect and understand that they put their patients first.
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| Dan Beckham |
A growing number of hospitals are finding their relationships with physicians strained. Despite the fundamental importance of this relationship, a surprising number of these institutions are paralyzed by the challenge of building productive and sustainable relationships with physicians. The task, they often lament, is simply too complex.
Unfortunately, doing nothing is not likely to be effective. In the absence of action, frustration and distrust will multiply on both sides, further undermining any possibility of useful collaboration. Doing something is a better alternative.
Physicians' Advice
I recently had an opportunity to talk to some physicians about what their hospital could do to lay the foundation for a more productive relationship. Their advice was straightforward and doable:
Get out of the executive suite and on to the floors. Some of the most important conversations take place in the hallways. Being visible on the floor makes you accessible to physicians and signals that you care about the vital work of your organization and the people who perform it.
Follow doctors around so you can develop a deeper appreciation for the world they live in. Get yourself invited to the OR and watch.
Visit doctors in their practices. All the physicians I talked to indicated that an executive from their hospital had never come to visit them in their offices. (Yet they always expected the doctors to come to the hospital for meetings.)
Sit in the waiting rooms of your emergency room, surgery areas and intensive care units so you can more clearly see your physicians' world from the perspective of their patients. Continue to work on patient satisfaction. Patients who have a bad experience in the hospital often transfer blame, frustration and anger to their physicians.
Eat in the physicians' lounge. Have your management team eat there, too. And engage the physicians who are there.
Don't delegate physician relationships. Chief medical officers and other physician executives are an asset to any hospital, but they don't take the place of CEOs who view interaction with physicians as one of the most important parts of their jobs.
Understand the economics of medical practice. Profitability in most practices depends on a completely different sense of scale than at a hospital. A physician's practice is a fundamentally different enterprise than a hospital.
Recognize that many physician practices (and many physicians) are run by their office staff. Make office staff feel valued when they interact with the hospital.
Respect physicians. A recent VHA study suggested that of nine characteristics, being treated with respect was No. 1 when it came to determining physician satisfaction with a hospital. It's clear that there are some hospital executives who genuinely dislike physicians. It's equally clear that these executives chose the wrong profession. I've gotten to know many physicians in the last 20 years, and even if I occasionally call them by their first name, I make a point of also calling them "doctor" with consistency. There's a simple reason for this. Aretha Franklin wrote a song about it: It's called "Respect." Surgeons and internists dedicate a minimum of 11 years to their training. It's not easy to get into those training programs, and it's not easy getting out. That reality, by itself, merits recognition and respect.
Involve physicians in creating the future. Doctors do come to the table and give generously of their time and best thinking when they feel their input matters. Sharing information with physicians helps them feel trusted. You can't trust unless you're trusted.
Make life easier. Another study conducted a few years ago identified proximity as the No. 1 determinant of physician loyalty to a hospital. This shouldn't have been surprising. Doctors sell two things: time and expertise. Anything you can do to help them leverage either will put loyalty points in your column. Make your ORs, ancillary services and information systems run efficiently.
Lose the halo. Running a nonprofit organization doesn't qualify you for sainthood. It's a blinding double standard to get indignant with physicians who demonstrate perfectly rationale economic behavior while the hospital employs coding consultants. And it's cynical and insulting to suggest that physicians are solely motivated by money. There may be some physicians who are obsessed by economic issues, but they constitute a very narrow edge of the bell curve. The vast majority of physicians put their patients first.
Recognize that the vitality of the physician community ultimately will determine the vitality of the hospital. When issues like the malpractice crisis threaten to crush your physicians, get in the car and head to the state capitol. Most hospitals are their community's largest employers. When six hospital CEOs show up representing the legitimate interests of their physicians, politicians will listen.
Despite the challenges confronting hospitals and physicians, some have found the higher ground and are working together to ensure that patient care always comes first. According to these physicians, a few simple productive first steps can get you on the right path.
Dan Beckham is president of The Beckham Company, a strategic consulting firm based in Bluffton, S.C. He is also a regular contributor to H&HN OnLine.
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This article 1st appeared on March 15, 2005 in HHN Magazine online site.
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