Unique Challenges to Setting Culture
It’s no coincidence that stress is a popular subject these days and has been the topic of several of our recent blogs. It’s not the sole topic of today’s Thinking Thursday TIPS, but it does play a role. Chronic stress has seemed to weasel its way into the limelight and left its grimy fingerprints on most aspects of daily living. Therefore, I’d be amiss not to mention it as at least one (if not the largest) hindrance to physician engagement in these unique times. Today we’re taking a look at how to create a culture within your healthcare facility that leads to improved patient satisfaction – specifically how to engage and motivate physicians towards that goal, taking recent hindrances into consideration.
Key Players = Physicians
Creating culture can often feel like turning a large ship around at the drop of a dime, especially for healthcare facilities with numerous locations. Setting a culture within your healthcare facility that leads to patient satisfaction starts with first: recognizing who your key players are and second: implementing intentional strategies to set them up for success. Although patients spend an average of only seventeen to twenty-four minutes with a physician (1), that short moment is often where patients form their opinions on the healthcare facility as a whole. The role of the physician within the patient’s experience is extremely significant. In his article for Health Catalyst, Dr. Bryan Oshiro points out, “[P]hysicians drive 75 to 85 percent of all quality and cost decisions.” (2)
Evan Howell writes in his article, “Ways to Improve Patient Experience: The Clinician’s Role,” “[W]hen doctors and APCs engage with patients in ways that make the patient feel satisfied, patients listen, follow instructions, fill and take medications, follow up as directed, have better outcomes, and physicians and APCs save lives.” (3) The role of the physician directly affects the patients’ engagement and health outcomes.
Molly Kramer takes it one step further in her article for Experity and writes, “An emotional connection with the patient can be as important as an accurate diagnosis.” It’s not new news that patients depend on their physicians for an accurate diagnosis, but I love Kramer’s addition of the significance of developing an emotional connection between the patient and the provider. No doubt about it, the role of the physician is the starting point to patient satisfaction and optimal health outcomes.
In order to set your physicians up for success, it’s imperative to prioritize their wellness, especially given the challenging circumstances many physicians have endured recently. In 2017, we published a blog regarding the challenges of physician engagement, specifically targeting physician burnout. Physician burnout isn’t a new crisis to hit America, yet the rates have grown exponentially and it still serves as a hindrance to physician engagement. According to Medscape’s news article regarding their latest survey, “Burnout and the stress of the pandemic (personal risk, social distancing, financial uncertainty) appeared to diminish physicians’ overall work-life happiness, with only 49% reporting they were happy in 2020 versus 69% pre-pandemic. More than one-third (34%) reported feeling unhappy last year, compared with 19% in 2019.” (4) For the first time ever, employers are having to take intentional measures to assess and ensure the mental wellness of their employees. Prioritizing the implementation of preventative measures against physician burnout is crucial.
Additional Barriers to Physician Engagement
I’d like to take a more in-depth look at the previously mentioned Health Catalyst article, “6 Proven Strategies for Engaging Physicians and 4 Ways to Fail.” (2) Dr. Oshiro’s writings include several very practical ways to encourage physicians while also exploring several ineffective strategies. I’ll summarize them for today, but I encourage you to give the article a more thorough read.
- Inspirational speeches
To put it plainly: while words can create initial hype and emotions, they are easily forgotten.
- Appointing physicians to key leadership positions:
Or more specifically, don’t appoint a physician to a key leadership position without training. Leading, organizing, and motivating others requires a completely different skill that elicits training and preparation.
- Financial incentives:
Dr. Oshiro writes, “Sure, physicians want to be paid for their time, but by and large, physicians are an altruistic group of people.” (2)
- Sharing of best practices:
Physicians are already busy enough; it’s not helpful (and oftentimes overwhelming) to share every single good practice with them.
- Discover a common purpose:
Begin by assessing and identifying any “silo-based” thinking or mistrust that’s occurring among the healthcare facility staff. Secondly, establish a common purpose or goal so as to create a culture of system instead of silo. For example, set the vision and/or common purpose of achieving better patient outcomes.
- Adopt an engaging style and talk about rewards
Dr. Oshiro writes, “Identify early adopters, the real physician leaders, and present this new leadership role as a career opportunity for them. This makes it easier to talk about rewarding efforts they could expect to see, such as a clinician or administrator promotion track and the maintenance of certifications. And then communicate candidly and often.” (2)
- Reframe values and beliefs to turn physicians into partners, not customers:
Include physicians in the decision-making process. After all, they are on the frontlines of patient care and can offer real-time insight. Furthermore, Dr. Oshiro recommends engaging their intellect by offering them opportunities to plan and lead initiatives towards improving patient satisfaction.
- Segment the engagement plan and provide education
Dr. Oshiro sums it up nicely: “Find the frontline folks who are seen as leaders in terms of the care they provide. Then educate them about the goals for the improvement efforts. Also, provide them with the support and training they will need to gain quality improvement skills.” (2)
- Use “engaging” improvement methods by using data:
Begin by collecting accurate, real-time data that points to the need for improvement. Then use this data to create and implement strategies for improvement that do not have to be perfected at first. Dr. Oshiro writes, “Physicians are perfectionists. But if the health system can show the benefit to making improvements in a safe manner, even if the improvements haven’t been perfected yet, physicians will realize that quality improvement is an iterative process. With this approach, physicians learn it’s ok to fail, but fail quickly, so they can learn and make adjustments to improve.” (2)
- Show courage and provide backup all the way to the board:
Dr. Oshiro writes, “Let physicians know the CEO will take their improvement plan suggestions to the board for approval, and the board and CEO will understand this is a physician-led initiative.” (2)
Owners Vs. Renters
Chances are high if you’re in management, you’ve heard of the analogy of the “owner employee” versus the “renter employee.” Igloo’s Dr. Jeanette Winters defines ownership mentality like this: “‘Owner employees’ take charge, fix what’s broken, reap the benefits of their efforts by honing in on specific objectives. Anyone adopting this empowering self-direction reaps the benefits of contributing, being candid (so leadership doesn’t have to guess at what is causing dissatisfaction), and drives solutions in their work around role definition and expectations.” (5) This type of employee stands in stark contrast to that of a “renter employee.” On which, Dr. Winters writes, “‘Renters employees’ allow others to define them, detailing what and how they do their job. S/he does as instructed – completing transactions or tasks as directed. They operate within the ‘lines’ that management lays out for them.” In order to create and promote a culture within a healthcare facility that leads to improved patient satisfaction, physicians need to have an “owner” mentality towards achieving that goal. Investing time and resources into better understanding physicians and prioritizing their care will set them (and consequently the entire healthcare facility) up for achieving improved patient satisfaction.
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Jerry L. Stone