Embracing risk-based care models could ultimately lead to better physician job satisfaction by creating stronger incentives for health systems to free them from low-value administrative tasks, according to Tufts Medicine CEO Michael Dandorph.
"One of the reasons we want to take on more risk is so we can avoid some of those administrative burdens and not replace them with something else, but truly eliminate the need for things that just really aren't improving the level of care, the cost of care or access," Mr. Dandorph told Becker's.
In a recent interview, Mr. Dandorph discussed the Burlington, Mass.-based system's approach to engage physicians in strategic decisions and relieve administrative burdens.
Editor's note: Responses were lightly edited for length and clarity.
Question: Physician recruitment has grown more competitive as market disruptors have entered the field. How has Tufts Medicine's approach to physician recruitment shifted in recent years as a result? What is the system doing to remain competitive and bolster retention?
Michael Dandorph: As an academic health system, we have a tight relationship with our university students and residents, as well as physician assistants, etcetera. First and foremost, we are really trying to expand our capabilities as a health system — not just at the academic center, but in our community settings as well, and exposing future physicians to our culture, experiences and opportunities that they may have at the very front end of recruitment.
We're always looking at compensation; we know that's an important aspect. As with other professions, flexibility is an important factor. Different physicians have different aspirations, needs and requirements. So we try to really meet the physician candidate where they are and be as flexible as possible in our recruitment.
We're also trying to create a destination workplace where people come and stay for the entirety of their career. So they see upward mobility; they see ways to accomplish the things that they're trying to accomplish within their career. We're interviewing those candidates from the perspective of "Do they fit our culture?" "Do they fit what we're trying to do strategically, and are they enthused about that?"
Q: In a recent survey, 83% of physicians reported being at or above workload capacity in their current practice. Overall, burnout rates are trending back in the right direction, though they remain high. Five years from now, what improvements do you see as realistic and hope to achieve when it comes to physician well-being and job satisfaction?
MD: We're having a lot of conversations with payers about how it serves both them and us if we can reduce the administrative burdens that often sit on the backs of our physicians. I do think that's something we can make a meaningful impact on in the short term; in the next three to five years, incrementally. How do we take some of that work away from the physician? Do we have to staff differently around it, or are there ways that we could just eliminate things that are really not adding value? One of the reasons we want to take on more risk is so we can avoid some of those administrative burdens, and not replace them with something else, but truly eliminate the need for things that just really aren't improving the level of care, the cost of care, or access.
Access is a plight most health systems I talk to around the country are challenged by. The demand is outstripping the capacity that we have, whether that's on the hospital side and certainly on the physician practice side. So we're trying to figure out, are there more streamlined ways that we can build care teams around our physicians so that the physicians are working at the top of their license, and have other members of the team assist them and support them.
In terms of documentation, there's a lot to be done in the short term. I know there's a lot of experimentation. Epic is deploying some capabilities in terms of using ambient sound and AI to help the physician with some standard documentation tools and templates. I think that'll be important, and I see that early on the horizon. I don't think that's five years from now; I think in the next 12 to 18 months, that's a big opportunity for us. We really have to focus on how to simplify things. We've added so much complexity that we really need to take a step back; almost a lean approach to what are the things that we're asking people to do that just aren't adding to the value chain.
Q: The theme of empowering physicians to return joy to practice comes through strongly in your message. What advice would you give to other health systems struggling to elevate and engage their physician leaders in today's challenging healthcare landscape?
MD: Most importantly, it really comes down to the leadership team making it a priority and making sure it's on the agenda. Coming out of COVID-19, we're all dealing with some level of the financial pressures related to contract labor and the workforce challenges.
But as we think about elevating the voice of our physicians and returning joy to practice, that needs to be talked about just as much as our finances among our leadership teams. I would even say that our financial performance and returning joy to practice to our physicians are going to be inextricably linked in the future. Second, it does really start with making sure that we have the forums to listen and engage — that has to happen across the organization so physicians feel heard. It can't just be a subset.
We're all trying to figure out what's next. What's the future; what's our strategy? Where might we want to divest of certain things — not just financially, but also in terms of orbital magnitude. Where might we prioritize or deprioritize certain initiatives? Bring more physicians around those strategic tables where forums are being set from a prioritization perspective; have opportunities to cascade and get input from our frontline physicians and staff, and equip them with tools to help them understand the strategies of the organization so they really become part of it.
Lastly, we have to find ways to enhance communication. We have not cracked this yet, but we're thinking about how we can reach all of our physicians effectively? We know they're inundated with emails; they're busy people. They don't want to come to meetings. How do we better communicate with these really important stakeholders in our organizations?