“How’s your physician engagement?”
I’m directing this question to hospital and health system leaders, because they often as for someone like me to help them with it. I’ve been asked many times by the C-suite to help them get their doctors engaged in Lean or other forms of process improvement. What I commonly find is that the most significant root cause is that the C-suite is not engaging with the doctors.
So before you call me in to help your engagement, here are some questions to ask of yourself and your team:
- Are you frustrated by the lack of engagement you see from your medical group or medical staff?
- Do you formally measure physician engagement in your organization?
- If you do measure, what are your results currently and where would you like them to be?
- If you were to rank order the many issues you deal with, where is physician engagement rank among your leadership priorities?
- How much time do you dedicate to physician engagement?
- Do you have a formal physician engagement plan? Are you leading it? if not, why not?
What doctors think about physician engagement
They don’t. That is until it gets raised as an issue in a department or medical staff meeting. They’re too busy trying to keep up with the demands of patient care to think about physician engagement.
- They do think about the challenges they have getting through their day.
- They think about how frustrated they are that they don’t have the resources they feel they need in order to provide patient care at the level of quality and compassion they think is right.
- They think that leaders in their organization don’t really care about the doctors and their challenges.
A 2015 physician burnout survey by VITAL WorkLife & Cejka Search found, “When asked if their organizations did anything to help them deal more effectively with stress and burnout, 81.5% of 2015 respondents said no, compared to 84.3% of the 2011 survey respondents. For those who responded yes, when asked what was offered, 52.2% of 2015 respondents noted there were wellness initiatives, followed by workshops and education (38.1%), social events (33.5%) and EAP, counseling or other behavioral services (32.7%).”
This is concerning on two counts. First, there was only a 3% increase over three years of physicians feeling that organizations are doing something to help with burnout. Either the vast majority of organizations were doing nothing more to help, or it was being done in a way that most doctors were not aware of, with no significant change in three years.
Second, the vast majority of what was being offered was treating the results of burnout, not fixing the root causes. The unstated message in this approach is that the root cause of burnout is the physician who needs counseling and therapy. Programs to help physicians cope with burnout are needed to stabilize and support doctors who are increasingly stressed, but they must be accompanied by work to FIX THE ACTUAL CAUSE OF THE PROBLEM – the dysfunctional clinical operations.
What causes physician burnout?
Burnout happens because we put highly motivated professionals into a workplace so poorly organized that the only way they succeed is through constant vigilance and focus. We enjoy engaging at a high level for a period of time. Doing so constantly is unsustainable. It wears doctors down and burns them out.
If you are a health care leader, and you are not personally engaged in fixing the dysfunctional clinical operations your doctors and nurses deal with every day, you are missing one of the most important priorities for modern health care leaders. If fixing your clinical operations is not at the top of your priority list, your priorities are misplaced. You don’t have to do it all, but you must be leading the operational redesign and improvement process.
How should a leader engage with physicians?
Here are a few key steps for leaders to engage with physicians, and thereby improve physician engagement:
- Make it an organizational priority and communicate frequently, widely, and using many modalities.
- Learn about burnout – read books and articles, attend presentations, and ask your physicians about it.
- Go see. Spend time shadowing doctors and nurses while they care for patients, observing first hand the frustrations your care givers deal with in your organization’s clinical operations.
- Offer help. Wellness programs and coaching help people who are on the edge. These are important. But don’t stop there.
- Implement a formal program to fix the broken clinical processes and transform your culture. Lean Done Right, based on the principle of Respect for People, is a great way to approach this comprehensively. As the organization’s leader, you must lead this effort.
So there you have it. Five steps you can follow if you are serious about improving physician engagement. You may be concerned that this process will put your other priorities at risk. Focusing on the physicians and nurses in this way requires investment of precious time and money, potentially diverting it from other priorities.
The great thing about this approach is that it provides a solid foundation for improving your performance on all the other key metrics – quality, safety, patient satisfaction, financial stewardship, and growth. And once you get into it, it is both an effective and fun way to lead. You might even bring joy back, not only to patient care, but to C-suite itself!