According to a recent survey from the Physicians Foundation, 82 percent of physicians believe they have "little influence on the direction of health care." At the same time, cost data suggest that physicians are the ones driving 80 percent of our increasingly unsustainable national health care spend.
While they may have different agendas and different priorities, physicians and health systems must find a way to agree on one shared purpose: delivering higher quality, more consistent care to the people they serve.
So what levers do health systems have to keep their physicians current and content? Let's take a closer look at how some health systems are engaging their physicians.
The Convenience Factor
With an estimated half of current medical knowledge becoming obsolete every five years, even the most experienced physicians have difficulty keeping up with all the changes in health care. Yet many bristle at the idea of spending time away from their offices at symposiums, or submitting to onerous exams on subjects that may not be relevant to their practices.
A recent article in The New York Times called "Stop Wasting Doctors' Time" revealed strong physician resentment for what they describe as archaic exams and paperwork-heavy assessments related to recertification and, instead, called for "periodic, modest-sized, open-book tests that incorporate relevant knowledge and updates." This is precisely the kind of experience that online physician communities, led by experts, can provide day or night from their mobile devices.
The Credibility Factor
Recent research published in the journal Physical Review X suggests that doctors are more likely to try a new therapy when they are persuaded to do so by an influential colleague. Building an online community of experts that physicians can trust, with clearly named and credentialed members, can lead to better care for their patients.
In fact, organizations like ours have seen plenty of evidence suggesting that virtual content can make a measurable impact on clinical care. For example, in the results of a physician survey for our firm:
Seventy-two percent of respondents said that online, expert-led content influenced how they manage acute asthma exacerbations in their patients. In 2010, according to the Centers for Disease Control and Prevention, asthma accounted for 3,404 deaths, 439,400 hospitalizations, 1.8 million emergency department visits and 14.2 million physician office visits. Reducing the number of asthma exacerbations has a huge impact on improving quality of life, increasing productivity, and lowering overall health care costs. In the words of one physician who interacted with an online community: "Patients forget how deadly asthma can be. Noncompliance is a big issue."
Sixty-seven percent of respondents said that online, expert-led content influenced how they diagnose, evaluate and treat patients with chronic obstructive pulmonary disease. COPD affects about 15 million Americans, and nearly half of them suffer from an exacerbation of their condition. Given the prevalence of this condition, the medical community is calling for new interventions to reduce the severity and frequency of exacerbations and the related cost impact of COPD. In the words of one physician who interacted with an online community: "I have become more sensitive to hearing and evaluating dyspnea complaints."
Fifty-nine percent of respondents said that online, expert-led content influenced how they manage the use of peripherally inserted central catheter lines in patients to reduce deep venous thrombosis rates. According to the Journal of Vascular Surgery, PICC lines account for up to 35 percent of undiagnosed DVTs, a major patient safety concern that also carries significant cost. In the words of one physician who interacted with an online community: "I have avoided PICC placement in at least two patients. I am charged with not only changing my own practices, but I also share knowledge with colleagues concerning non-judicious placement of PICCs."
Examples like these point to improvements in patient outcomes and the opportunity for health systems to facilitate physician access to online content that physicians want and respect. Physicians who engage with these kinds of digital tools are better equipped to deliver high-quality, consistent and cost-effective care.
The Feedback Factor
Several industry experts — including those whose articles have appeared in this publication — have underscored the growing need for health systems to build trust with their employed physicians.
In fact, a recent survey of our own physician community found that employed physicians rank "integrity" as the most motivating characteristic of health system leaders. While 80 percent of respondents name that as the quality they most admire, only 40 percent of them say their health system's leaders exhibit such integrity.
What physicians say they need to be successful and what they experience may not always align, yet the more opportunities that health systems take to solicit their physicians' feedback and let them participate in decision-making, the easier it is to gain physician buy-in on the bigger organizational objectives. Health systems that use digital interactive technology and content to engage physicians have created a real-time approach to hearing the "voice of physicians," and have the immediate opportunity to document what physicians know and don't know about key components of their clinical integration strategy.
For example, according to the Advisory Board, clinical integration is one of the few ways that health systems and independent providers can work together to meet the demands of population health. Of course, it won't happen without physician buy-in.
Members of our physician community who have spent time exploring expert-led content on clinical integration (2,240) rank the top three barriers as "transition costs" (60 percent), "culture change" (53 percent) and access to "timely data" (45 percent). Yet these survey respondents also point to opportunities, such as new practice roles that don't require a medical degree to promote successful clinical integration. Specifically, these surveyed physicians would like to see roles such as care coordinators (71 percent) and disease case managers (64 percent) added to their practice.
By opening up the communication channel to provide feedback to health systems through digital technology, physicians are given the opportunity to be part of a solution that aligns with the broader health system's objectives.
Factor in Value
In some ways, technology — such as information systems that often seem to restrict individual practice — may be to blame for the lack of physician engagement that many health systems report. And of course, this lack of engagement contributes to unnecessary cost and quality variation, and even personal frustrations.
But the more technologies can deliver value consistently to physicians — in the form of credible content with which they can interact, and available whenever and wherever it's convenient for them — the more value these physicians stand to deliver to their health systems and the people they serve.
Dan Malloy, Ph.D., is the executive vice president of Quantia Inc. in Waltham, Mass.