While the majority of physicians — 64.2 percent — feel highly engaged and passionate in their work of treating patients, just 41.5 percent feel engaged with their organization, a Physician Wellness Services and Cejka Search survey found.
There are several reasons for the phenomenon, especially with the trend of hospitals and health systems employing physicians, according to Dan Whitlock, MD, MBA, a consulting physician with PWS. Many times, acquisition or merger decisions involving a practice or medical group are made from the top, and all physicians in the group are expected to follow.
"They go from being self-employed and satisfied, to being employed by a large system and feeling like just a cog in the machinery," he says. "Physicians have a wealth of patient-centered experience and it's a profound loss if health systems fail to harness — or even disregard — this hidden treasure. Plus, the survey found that physicians' feelings of engagement are strongly influencing their decisions around accepting a position or remaining with a practice."
The survey found that all 15 elements of engagement that were presented in the survey were very important to physicians. Here, Dr. Whitlock walks through the five areas physicians ranked as the most important to being engaged with their organization and tips for how hospital and health system administrators can improve on each.
1. Respect for their competency and skills. Physicians ranked this as the most important area in regard to their engagement with an organization. "There needs to be an opportunity for physicians to lead and participate in organizational initiatives," Dr. Whitlock urges. Hospitals should also provide career or skill growth opportunities to their physicians, he says.
2. Feeling their opinions and ideas are valued. Many hospitals host meetings, which "scores of physicians" attend, to gather ideas and hear from their physician staff. However, this is not enough on its own to have physicians feel they are being heard, says Dr. Whitlock. In those meetings, not every physician feels comfortable speaking his or her mind.
"The closer administrators can get to the physician, the better communication works," notes Dr. Whitlock. "Attend department meetings, when possible, and stop by an individual physician's office to ask for his or her opinion one-on-one." In Dr. Whitlock's experience, physicians love to be consulted by colleagues and administrators, and leveraging this conveys respect. Also, administrators should arrange smaller, more informal meetings to make sure many physician voices and opinions are heard.
"Another effective technique is to pick out a physician who is not, nor ever will be, engaged and invite him or her to give their opinion one on one, in their office. You may learn a lot about them and yourself at the same time. In addition, you might gain an ally."
3. Good relationships with physician colleagues. One easy way for hospitals and health systems to foster positive relationships among their physicians is by providing opportunities for gatherings outside of work. Sending a group of physicians to conferences on the delivery of care is one way to do this, Dr. Whitlock suggests.
Also, administrators should sharpen their intelligence to the existence of pockets of physician-to-physician conflict so it can be addressed earlier and thus, more effectively. Hospitals can also offer conflict management programs geared specifically toward physicians. "A lot of physicians haven't been taught skills for how to settle a conflict," he says. "It's a good investment which prevents escalation to something that may end up on your desk."
4. Good work/life balance. Physicians have become less likely to join organizations that don't allow them to practice shift medicine, according to Dr. Whitlock. One common way hospitals can promote a good work/life balance is by using a hospitalist model. However, there are other steps hospitals can take to improve the balance of its physicians' lives.
• Work with physicians on setting patient loads. "Physicians have difficulty saying no to requests on squeezing patients in," says Dr. Whitlock. Hospitals can provide coaching for physicians to better delegate their work to avoid this issue.
• Start a concierge service. Concierges can serve a variety of purposes when it comes to lightening physicians' loads. They can do everything — from setting dinner reservations to finding a dog boarding service to helping with vacation plans — saving time for busy physicians and their families.
• Provide support groups. The groups are a safe space for physicians to talk and share their feelings about work and the profession in general. "It's amazing how uniform [some] feelings are but how reticent physicians are to talk," says Dr. Whitlock. "But it's not healthy to keep these things feelings of guilt and self-doubt in."
• Provide peer mentors from within or outside of the organization to physicians who are struggling with work-life balance. Suggestions from peers are often highly effective in overcoming barriers many physicians have around seeking help.
5. A say in how their time is structured and used. When administrators are in control of the scheduling process, physicians often feel like they are on an assembly line of seeing a patient every 10 minutes, says Dr. Whitlock. "Physicians know how much time they need with patients. Some problems won't wait and some can be handled more expeditiously," observes Dr. Whitlock. Administrators need to recognize that one size does not fit all, and all physician-patient contacts are not equal in terms of intensity. "Open this thorny dilemma to the creativity of your physicians and follow their advice," Dr. Whitlock suggests. "Time with patients is a very personal issue with physicians so this is one key area to let them take the lead."
"There needs to be regular meetings with physician administrators and clinical managers to offer opportunities to problem solve on workflow," Dr. Whitlock says. If there is no structured time to do so, physicians are not likely to ask for help, "so having structured time for this discussion is very important," he explains.