As CEO of Tufts Medicine, Michael Dandorph always has an eye out for ways to involve physicians in strategic decision-making and enable them to have greater control over their practice.
"We're trying to involve physicians more and more, even in things that aren't necessarily clinical, but more administrative, to get their input before we set policies or move initiatives forward across the organization," Mr. Dandorph said in an interview with Becker's.
Time and again, physicians point to a lack of autonomy and involvement in organizational decisions as drivers of job dissatisfaction and burnout. When asked how their employers could improve workplace culture as part of a 2024 Medscape survey, being consulted on organization and policy decisions emerged as physicians' top response. A separate survey from this year found that only half of physicians in health system-led practices are satisfied with their role in strategic decision making, indicating a key opportunity for health systems to enhance physician engagement and retention.
This is a key area of focus for Burlington, Mass.-based Tufts Medicine, which operates a network of more than 2,300 physicians.
"Our industry has done a bit of a disservice to physicians over the years," Mr. Dandorph said. "We've burdened them with an array of administrative processes, documentation requirements, and in a lot of ways, unjustified bureaucracy with just getting things done — and that openly keeps them from focusing on things they want to achieve with a patient, or for a physician scientist, they may not necessarily be able to achieve their aspirations. Ultimately, we have to find a way to simplify their lives."
To strengthen communication and collaboration, Mr. Dandorph formed an advisory committee of 20 physicians from various specialties shortly after becoming CEO in 2020. Every few months, he meets with the group for several hours to identify new opportunities to improve workflows and ensure physicians are involved in the planning process on major projects.
One opportunity that arose from these discussions was the need for a new structure to manage the health system's value-based care agreements. When Mr. Dandorph joined Tufts, the system operated two separate clinically integrated networks. In response, leaders tasked a group of physicians with designing a single, unified network. They decided what the overall structure of the network would look like, how it would be governed and set accountabilities for participation.
The network went live several years ago and now includes the majority of the system's physicians — both employed and those in private practice.
"[The physicians] really take accountability for the performance under our value-based care contracts," he said. "It was designed by them, so there's a greater level of ownership in that strategy and it positions us better," to advance in value-based care, which has been a major focus at Tufts for more than a decade, Mr. Dandorph added.
Last year, the system joined Blue Cross Blue Shield of Massachusetts' pay-for-equity model, making it one of the first in the nation to participate in contracts that tie financial incentives directly to measurable improvements in health equity. In April, Tufts partnered with Navvis, a population health company, to scale value-based care capabilities and improve clinician workflows across the enterprise — a decision that was fully led by physicians.
"It's a partnership between them and obviously the health system in terms of the investment, but it was really about us listening to the physicians in terms of what's important," Mr. Dandorph said.