Strong physician engagement benefits a hospital or health system's quality of care and financial performance. However, few healthcare executives fully understand how to obtain and sustain physician engagement.
This article is sponsored by Integrated Healthcare Strategies, a part of the Gallagher Human Resources & Compensation Consulting practice.
The shift from fee-for-service medicine to value-based payment models makes a highly engaged physician workforce more critical than ever before, as healthcare organizations seek to provide higher quality care, improve outcomes and decrease costs. Physicians drive the majority of cost and quality decisions at hospitals and health systems, and a disengaged physician population can have significantly negative effects on the organization as a whole.
Since strong physician engagement is vital to a hospital or health system's success, many provider organizations are looking for ways to improve physician surveys to more accurately gauge engagement, David Rowlee, PhD, Managing Director & Practice Leader of the Engagement Surveys service line of Integrated Healthcare Strategies, a part of Gallagher Human Resources & Compensation Consulting practice, said during an executive roundtable April 13 at the Becker's Hospital Review 9th Annual Meeting in Chicago.
Dr. Rowlee and his colleagues have helped Integrated Healthcare Strategies develop a robust survey with several categories to measure physician engagement. "Our measure of engagement has a lot of what you would treat as classic markers of engagement," such as wanting to be part of the organization, he said. However, the survey also includes metrics that are quite different than those on a traditional survey.
Most surveys largely focus on how the physician is benefiting the hospital or health system by asking questions such as whether the physician would recommend the organization. After reading some literature a few years ago about the benefits of thinking of engagement as a reciprocal measure, Dr. Rowlee and his colleagues decided to take a slightly different approach. The survey now not only examines how the physician benefits the healthcare organization, but also how the healthcare organization benefits the physician. For example, the survey includes questions to gauge whether the physician's affiliation with the organization helps keep him or her passionate about the practice of medicine.
This new engagement metric "dramatically increased our ability to actually predict whether or not engagement is actually doing anything to help these business outcomes," said Dr. Rowlee. "That was something that was a particular game changer in terms of the approach we were using for measuring engagement."
Key tips for driving physician engagement
Physician engagement surveys give hospital and health system leaders insight into how physicians perceive the organization and its services. Armed with that information, provider organizations should closely examine factors that contribute positively or negatively to engagement and work to improve physicians' daily experience.
While engaged physicians are energetic, enthusiastic and truly committed to improving their organizations, disengaged physicians pose a serious impediment to a hospital or health system's goals, said William F. Jessee, MD, FACMPE, Managing Director and Senior Medical Advisor of Integrated Healthcare Strategies, during the roundtable discussion.
"Physicians who are not engaged tend to turn over," he said. "What is even worse is physicians who are not engaged not turning over and becoming toxic in the organization."
There is no magic formula for physician engagement, and the factors fueling engagement continually shift. However, the executive roundtable participants identified three main drivers of physician engagement that remain relatively constant.
1. Invite physicians to join in leadership. "What really drives people intrinsically is having value or purpose of some sort, having some type of voice or autonomy and being able to master their craft," Joseph Blonski, MD, Physician Vice President of ambulatory care at St. Cloud, Minn.-based CentraCare Health, said during the roundtable discussion. One way to ensure physicians know their voice is actually heard is to identify leadership opportunities for physicians and invest in formal and informal leadership development opportunities.
The leadership roles physicians take on come in a variety of forms, including full-time, part-time and volunteer positions. During the roundtable, the president of a clinically integrated network in Idaho said physicians at her organization are extremely interested in volunteer leadership positions. "We're fortunate to have 55 volunteer physicians on our committee," she said. "What we've recognized is we have more volunteers than committee slots."
2. Bridge the gap between physicians and administrators. Although physician leaders and operational administrators once operated in distinct silos, that leadership model can leave physicians disengaged. As the industry shifts toward value-based care and more organizations form integrated delivery systems, adoption of a dyad model of leadership is on the rise. Dyads involve physicians and operational leaders, who work together on some level of management.
This leadership model can foster trust and a sense of connection between physicians and administrators and help the organization solve issues more efficiently by combining administrative expertise with clinical excellence. Although the benefits of this type of model are compelling, some healthcare organizations fail to achieve success due to subpar implementation.
During the roundtable, Dr. Blonski discussed CentraCare's experience with a dyad leadership model and how it helped physicians feel more engaged. He cited the need for an early and strong strong focus on training and mentoring physicians selected to serve in these leadership roles. If the coaching and training is properly executed, Dr. Blonski said this model can have a trickle-down effect, as the dyad section leaders then share their training with their colleagues.
3. Don't rely solely on compensation. In the quest to improve physician engagement, many provider organizations focus too heavily on compensation. While competitive pay is important to most physicians, greater compensation does not necessarily lead to higher engagement, according to Dr. Blonski.
"The compensation is kind of a given. It has to be fair. After that, throwing more money at people doesn't really do much," he said.
Conclusion
The importance of strong physician engagement is growing as the healthcare industry shifts toward models of care that focus on improving patient outcomes and efficiency. The process of strengthening and sustaining physician engagement can be challenging, but it is also synonymous with improved hospital performance and patient outcomes.