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Five Fixes to Improve Doctor Collaboration

December 17, 2015

ThinkstockPhotos-122569320In a recent post for the New York Times Well blog, Dhruv Khullar, M.D., notes that, “Though new models of healthcare delivery increasingly focus on collaboration, medical education still does not adequately teach aspiring doctors how to work effectively with a team of caregivers”

Khullar is a resident at Massachusetts General Hospital and Harvard Medical School. He notes that medical students don’t study or train with other professionals. They aren’t taught how to understand their fellow clinicians' roles and limitations. Training on collaboration, communication, and healthcare-specific emotional intelligence skills is also missing from most residency programs. If it happens, it’s informal and relies on individual initiative or supervising physicians and mentors who value these skills.

We often refer to the work of Dr. James K. Stoller of the Cleveland Clinic. Stoller is an M.D. and has a Masters in Organizational Development. In his article, “Can Doctors Collaborate”, he outlines why the way people are selected for medical school, the education process, and the professional culture, actually discourage the development of collaboration behaviors.

Over the past few years, more of our clients have asked us to help apply executive level behavioral competency concepts to physicians and physician leaders. We’ve used executive assessment tools to help select and develop physician leaders, created new physician interviewing tools to better understand candidate strengths and weaknesses, and implemented physician-specific behavioral assessment tools to improve self-awareness as the first step toward developing these behaviors.

Here are the steps we see as necessary to build the next generation of highly collaborative physicians and physician leaders:

1. Incorporate behavioral skills into medical school and residency training

I’ve been hearing this from physicians for years. Perhaps the demands of healthcare reform will force the issue. I realize that the medical school curriculum is crowded and time is precious. But patient outcomes and career success and satisfaction are dependent, to a significant degree, on more than clinical knowledge and skills. Let’s at least start the discussion in a meaningful way about the role of physician as a leader, about
emotional intelligence, communication and collaboration skills.

2. Define and communicate physician-specific behavioral expectations

It may seem like an unnecessary exercise, especially to busy physicians, but how can we expect physicians to change behaviors if we haven’t really defined the expectation? We do it for the most senior positions in any organization. What do we MEAN by collaboration? What specific behaviors are we looking for and what behaviors are unacceptable? Some organizations use a physician compact – that’s a starting point, but it tends to be too broad for teaching new behaviors.

3. Re-think the physician interview

Interviewing a physician is different. It’s a seller’s market. You are usually working hard to sell the physician that she should choose your organization. Physician candidates don’t expect a “standard” interview structure of probing questions. That doesn’t mean, though, that we can’t add some structure to the interview and think about the physician as an important executive. Give those interviewing physicians some level of training so they aren’t susceptible to typical interviewing errors. Incorporate targeted behavioral content to begin to glean useful information about how the candidate works and thinks. Is she collaborative? Adaptable? Innovative? Think about the last physician you brought on board that didn’t fit your culture or your expectations. Would a skilled interviewer have picked up on the issue?

4. Individual developmental plans

Start with something - some plan identifying mutually acceptable performance goals and a few areas where behaviors, including collaboration and leadership, can be improved and the resources to do so. A physician is an important and expensive asset. Don’t leave success or failure to chance. We’ve been using several tools designed specifically for physicians to help them understand their natural behavioral strengths and weaknesses.

5. On-going medical staff discussion and training on collaboration and leadership skills

The medical staff, as a whole, needs to recognize the need and support efforts to improve individual and group performance. Physician leaders need to identify specific collaborative opportunities and lead frank discussions about why collaboration is important and how to improve it. Physicians we work with report that basic training, for instance, on group facilitation skills can be incredibly valuable. A culture of collaboration will only happen when physician leaders embrace it, and a deliberate approach to getting there.

This isn’t just an issue for hospitals who want to maximize performance reimbursement. In this new world, it’s an issue that goes to physician success and career satisfaction. Practicing medicine can be frustrating enough. Just like every other profession, though, those with behavioral skills and emotional intelligence handle change better, can navigate organizational challenges and are far more likely to find career success and become successful, and fulfilled, leaders.

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Bryan Warren Bryan Warren was the former Director of Healthcare Solutions at PSI. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.