The United States leads the world in healthcare spending, devoting almost 18 percent of its gross domestic product to healthcare costs—and that percentage is slated to continue rising. But this financial burden is not sustainable. In an effort to reduce the overall strain on the government, CMS has tasked healthcare systems to provide higher quality care, decrease costs, and improve outcomes as rapidly as possible.
Making significant improvements is not an achievement organizations can do without physician engagement, though. They need physicians to be on board. Why? The reality is that physicians play a large role in the complex mechanisms of healthcare delivery. From providing frontline care to filling leadership positions, physicians drive 75 to 85 percent of all quality and cost decisions. That’s a mighty large percentage, which translates to significant financial losses if physicians are disengaged and don’t participate in improvement initiatives.
A survey by Gallup highlights the importance of engaged physicians: for one hospital alone, there was a 26 percent increase in productivity for engaged physicians over disengaged physicians. In other words, one engaged physician adds an average of $460,000 in patient revenue per year. Not a source of revenue to ignore when many health systems only have about two
percent operating margins to work with these days.
To obtain high levels of physician engagement, it is important to understand why some physicians are reluctant to participate in the quality improvement process.
First, because of recent regulatory changes, physicians are preoccupied with concerns about losing their autonomy and seeing a drop in income levels. They are also struggling with increased patient loads and dealing with the onslaught of new regulations and requirements—all without any guidance on how to survive the new value-based care environment. A McKinsey report highlights four other key concerns and barriers:
Because of the many uncertainties facing physicians, it’s easy to understand why so many feel anger and sadness right now. More information about the various stages of grief physicians are experiencing can be read in this Harvard Business Review article.
So how does a health system encourage physicians to play a positive and constructive role to drive cost and quality improvement initiatives? One key method is for the organization to send the message they want to focus on improving patient care. An objective like this has more value to physicians than goals to reduce costs and improve standardization and waste.
In addition, physicians and the healthcare system must share a noble purpose. Hospital administrators must acknowledge the journey will be difficult and there will need to be sacrifices along the way. Administrators must also convey their willingness to support the physicians for the long haul, provide clear expectations about why change is necessary, and give physicians time to agree with the rationale for the change. In addition, it’s important physicians receive clear messages about what is expected from them during the change process.
While there are different types of strategies an organization can use to encourage physician buy-in, some have proven to be successful while others simply don’t work.
Strategies that don’t work
Strategies that do work
Having great leadership and creating a focus on a shared vision are critical components to encouraging physician buy-in. Rather than viewing healthcare’s problems as just that—problems—they should be seen as challenges that can be overcome. To do this effectively, someone needs to come along, point out the vision, and then lead the physicians in the right direction.
In addition to great leadership, physicians also need to see the organization as a partner, a partner they can believe in. A partner that will help them. A partner that will not only work to improve the lives of their patients, but all of the lives the organization comes into contact with, including the lives of the physicians. According to research by Gallup, a healthcare partner like this will foster physician engagement by giving physicians the following: confidence the health system can be trusted to deliver on its promises; the belief the health system will act with integrity and treat them fairly; a clean and efficient facility they can take pride in; and a workplace they can be passionate about.
Without a plan, a strategy to gain buy-in can be difficult to achieve. The Institute for Healthcare Improvement put together a framework of six elements to encourage physician buy-in for a shared quality agenda. The framework covers the following objectives and explains why they are important:
Improving the delivery of care and reducing costs are critical in today’s world of value-based care. But achieving these improvements requires physician buy-in because their decisions drive the majority of quality and cost outcomes. It’s critical to create a shared vision that aligns the health system and the physicians. Then provide the administrative support, data analytics and reporting, and the training necessary to do meaningful improvement work. Listen to their concerns and address them. Actions will always speak louder than words, so make your actions speak wonders to your physicians as a way to develop a relationship of trust. Once you have their trust, you’ll get their buy-in and enthusiasm to move forward with quality improvement efforts that will benefit everyone. This will enable the organization to achieve success during an era of massive changes to its industry as a whole.
Are you also facing physician engagement challenges as you implement quality improvement efforts? What have you done to improve these vital relationships?
Would you like to use or share these concepts? Download this presentation highlighting the key main points.