Three Essential Steps to Achieving Active Physician Engagement

Three Essential Steps to Achieving Active Physician Engagement

May 2014

In a post Patient Protection and Affordable Care Act environment, it may come as no surprise that that health systems are clamoring to join forces with physician practices to preserve their patient base and remain financially stable.  What is surprising, however, is that while physician employment is on the rise, physician engagement is still missing the mark.  A recent report by The Advisory Board shows that 60% of employed physicians are not actively engaged, a statistic supported by the fact that relationships between health systems and local physician constituencies have historically been strained.  This gap is recognized in the industry as a next key hurdle to transforming the delivery system.

Health system executive leadership can help set the tone of how the physician enterprise is brought into the health system.  In order to motivate the physician group beyond the specific practice-level focus and into a more unified organizational focus, executive leadership should focus on three key elements:

  • Preparing the culture
  • Initiating a critical reason to change
  • Understanding stakeholder expectations

Preparing the Culture

When a family expands, there is typically a moment where the parents sit down with members of the family and prepare them for the new addition in order to make the transition smoother. They discuss how roles will change, recognize that the change may be a difficult adjustment and encourage enthusiasm about the new addition.  When an entrepreneurial business such as a physician group is inserted into a health system bureaucracy, this type of discussion is just as critical to prepare the health system or hospital for the integration.  The hospital or health system’s culture must be adjusted to accommodate physician input and allow physicians to have a seat at the table—to be actively involved in influencing strategy and making decisions.  Executive leadership must form the beliefs and shape the experiences that will lead to true culture change within the organization.

Initiating a Reason to Change

When two different entities join forces, change is inevitable – for both parties. Getting both sides to accept and champion the necessary changes is no small act. However, this process can become easier if both parties have a shared reason to change. Defining a “burning imperative,” or critical reason to change mantra, is an effective tool to keep people focused on a common goal. Once a clear vision is established, teams become more flexible in their actions and reactions, because everyone is confident that the team members are working toward the same goal. Decision-making has a greater chance of occurring collaboratively at the ground level. In addition, those who stand in the way of progress are viewed as negatively affecting the whole organization. 

For the burning imperative to be effective, it must be:

  • Broad enough to appeal to a wide group
  • Created collaboratively by hospital leaders, staff and physicians
  • Communicated actively and continuously by leadership, creating sponsorship and constituency.

When both the health system and physician enterprise work together to develop the critical reason to change, it can spark the energy needed to redesign the relationship between the two groups and open the door for active engagement.

Understanding Stakeholder Expectations

Hospital leaders, physician and staff are more than likely to have different expectations for the health system – physician enterprise integration. These expectations not only vary from role to role, but from individual to individual. Understanding the individual perspectives and level-setting expectations will go a long way in clearing up misunderstandings and building trust within the entire organization. Ideally, before the integration takes place, executive leadership would conduct interviews with both physician and non-physician stakeholders to understand each person’s expectations. In this way, all stakeholder opinions are actively included in the decision-making process and organizational strategy and tactics. Moreover, understanding expectations gives leadership the ability to understand motivations and behavior to better shape communications.

Stakeholder assessments can still be valuable even if the physician enterprise is well on its way to integrating with the organization.  Regardless of when stakeholder assessments are conducted, the results can be used to develop strategic business initiatives to move beyond the current plans, expectations and vision and move together towards the future. 

True physician engagement facilitates cooperation between hospital organizations and physicians. A combination of creating the right culture, establishing a common reason to change and understanding expectations with clear, consistent communication will help move the organization beyond physician employment and toward active physician engagement.