This article was forwarded by a physician friend: How Hospitals Discourage Doctors, A Step by Step Guide – it’s the story of a doctor finding a document encouraging hospitals to give up on partnering with physicians in favor of simply controlling them. Some have suggested it’s satire, but I’ve spoken to physician and hospital leaders who admit that some leading voices (particularly consultants) are encouraging this very strategy. It’s sad – and misguided.In order to successfully tackle the challenges facing our health care system, hospitals and physicians need to collaborate on a whole new level. I think this new idea of giving up on collaboration arises out of frustration on the part of hospitals – frustration borne out of their failure to understand how to really collaborate with physicians. The most successful systems learned a long time ago, that hospital leadership and physicians have the same goals and can work together to succeed. Sure, physicians can be tough to deal with, if you don’t understand how physicians think or how important they are to your success. When this happens, the hospital defaults to “I really just want them to do what I want them to!”
Too often, this is what a hospital means by physician “engagement”. It’s why I promote physician-hospital “alignment”. When this happens, goals are aligned and physicians are seen as valuable partners in developing an integrated care network, in understanding the role of physician performance and success – within the context of overall system success. When this happens, physicians are valued and there is a structured approach to selecting and developing physicians and physician leaders who take accountability for success of the whole.
I’d point you to two great articles out this month:
- Better as Partners is in the September issue of HealthLeaders. The subtitle: “Employing physicians is rampant, but it’s far from sufficient for alignment.” We’ve talked about this in the past. Employment is NOT the same thing as engagement or alignment.
- The Physician Leadership Journal published “Understanding Physician Engagement – and How to Increase It.” Citing a recent survey of physicians, it identifies gaps between the elements of successful engagement and what they are experiencing:
- “Feeling that my opinions and ideas are valued”
- “A voice in clinical operations and processes”
Hospital leaders want physicians to be “engaged”. Of course they do. Physicians, however, don’t want to be the “targets” of these engagement efforts. They want a seat at the table. This means they need to assume a leadership role and appreciate that the board room is not the OR and requires a different type of leadership. Physicians need to take ownership of what it means to lead in a collaborative manner. The hospital needs to think about what it means to “align” with its physicians and what real collaboration looks like.
They would make progress if they started with two simple concepts:
- Recognize that employment does not ensure engagement OR alignment
- Make it crystal clear to physicians that their expertise, work and opinions are valued – so much so that they are needed in developing the organization’s vision, and how it will be realized in the blocking and tackling of clinical operations and process.
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