BY LOUIS CARTER
CEO and Founder, Best Practice Institute, West Palm Beach, FL
Give physicians the right tools, technology and supportive environment required to thrive daily, and they will be much more willing to put up with the pressure, on-call shifts and time away from their families. Health system leaders often need to catch up on this extremely important point. The healthcare industry has almost entirely corporatized. However, it is also true that most physicians continue to adhere to the moral standards that initially drew them to the profession; and that is what compels many physicians to work in hospitals. Corporate medicine has extracted nearly all of the system’s “efficiency.” The productivity figures can stretch only so far with restructuring and mergers. However, the professional integrity of medical staff members is one resource that looks endless.
The enterprise as a whole is held together by this ethic. Patients would suffer terribly if doctors and nurses left their workplaces after their paid shifts were over. Nurses and doctors don’t do it because they know the repercussions. Over the past few decades, the pressure put on medical personnel has increased steadily without a corresponding increase in time or resources. Patients will only get the care they need if doctors and hospitals work closely together. In light of these conditions, hospitals must plan improvements to attract and keep the best doctors, ultimately benefiting patients. Here are four ways hospitals can stop working against physicians so patients can get the care they need and deserve.
TRANSFER NON-PHYSICIAN DUTIES TO OTHER HOSPITAL STAFF
According to an article on AMA Wire, MultiCare Health System (MHS), located in Tacoma, Washington, developed the Provider Wellness Program to identify and solve the main reasons behind its doctors’ and advanced practice providers’ workplace inconveniences. The health system discovered that, at too many organizations, doctors perform many duties that other non-medical staff can quickly complete. For example, a staff member can schedule endoscopies and screenings for patients, but often physicians have to do it.
Hospitals can reduce physician burnout by letting team members manage work that accumulates in the in-basket of the online medical records systems, such as lab results, patient messages and queries, as well as requests from care homes or referring providers.
ENSURE BETTER WORK/LIFE BALANCE FOR PHYSICIANS
Providing a better work/life balance is becoming more critical for hospitals, as 92 percent of young doctors say it is a top priority. Doctors are driven away by burnout and discontent; those who remain are less likely to offer patients high-quality care. Most doctors and nurses find it impossible to leave their work unfinished because doing so could endanger their patients. I will abstain from charging the system with creating a deliberate business plan to exploit medical professionals for free labor. Instead, administrative creep is to blame.
The medical staff members, especially physicians, are burdened with one additional assignment after another because they can’t and won’t refuse them. People continue receiving prescription drugs, having surgeries and visiting doctors’ offices. From an administrative standpoint, everything is running smoothly.
All is not fine, though. Doctors are experiencing unprecedented levels of burnout, which is much worse than the general population and is steadily rising. The World Health Organization (WHO) has acknowledged the detrimental effects of burnout from prolonged professional stress. More medical professionals are committing suicide each year than nearly any other occupation group. Nurse burnout is also rising and is highest among those who provide direct patient care. Increased burnout is also linked to increased instances of medical error and decreased patient safety. This situation cannot continue, neither for medical personnel nor the patients that depend on them. The people in charge must consider the effect of their decisions. It’s more than just a lousy tactic to rely on nurses and doctors to put up with it because you know they won’t abandon their patients. It’s medical malpractice. Doctors need support to continue providing the care patients need and deserve.
One of the top priorities for doctors is scheduling flexibility, allowing doctors to share their workload or work part-time. Consider rotating on-call duties to give doctors more time to enjoy their free time without any disturbance. It can be an excellent way to lower the burden on physicians to help them avoid burnout and achieve work/life balance.
STRIVE FOR ALIGNMENT BETWEEN PHYSICIANS AND HEALTH SYSTEMS
According to research published by the Harvard Business Review, one of the core problems plaguing U.S. healthcare is the need for more alignment between doctors and health systems. The conflict between enhancing clinical quality and reducing costs, including coordinating physician compensation with value-based payment systems, is one of the major causes of misalignment. The burden of logistical and documentation work, such as maintaining electronic health records, on doctors who would instead devote that time to patients is another problem causing misalignment. These problems will impede efforts to provide high-quality, reasonably priced healthcare.
Hospital management must take action, because the quality of care is at risk. Disgruntled patients, poorly coordinated care, unequal access to care and rising expenses are issues that have troubled the healthcare system but have worsened during the Covid-19 pandemic. Health systems faced their distinct epidemic as the country battled the crisis, which saw a steep rise in physician discontent and burnout. Health systems’ effectiveness and resilience depend on having coordinated, cooperative partnerships with physicians. These relationships require time to develop with honesty, transparency and trust.
New care delivery models appear. Improvements are made in production, quality and efficiency, all of which improve the financial performance of the hospital/healthcare facility. Alignment, however, is relatively easy to achieve. It is because alignment happens at physicians’ discretion, and the onus is on hospitals/healthcare organizations to convince them to make that choice. Getting physicians on board involves a person-to-person strategy that begins with establishing shared organizational values and a purpose for the health system, with physician input. To achieve alignment, leaders must consistently remove friction points along the path. It requires will, commitment, grit, tactics, supporting resources and iteration.
DEFINE THE ALIGNMENT’S CONDITIONS
As a result of the fragmentation of American healthcare, patients typically receive poorly coordinated and uncentered care. Physicians are crucial in determining the costs and outcomes of the healthcare system because they are the ones who write prescriptions for treatments.
Physicians would have to take the lead in implementing these changes and ensure they were founded on shared organizational values if hospitals were to improve healthcare’s efficacy, safety and cost.
By identifying and systematically implementing “guiding principles of professionalism,” doctors, CEOs and board members can lay the groundwork for this. The values embodied by these pillars—which include practicing medicine responsibly and with compassion, embracing evidence and educating oneself and others in the interest of patients—represent the qualities of physicians and, most importantly, principles.
CHOOSE EXEMPLARY MEDICAL PROFESSIONALS TO DRIVE THE CULTURAL CHANGE
Organizations should encourage clinicians to identify colleagues who have embodied the above-mentioned pillars through their leadership and practice. These physicians should subsequently be honored at a formal event. The approach grounds the principles in real people rather than just words. It serves to demonstrate the organization’s overall dedication to the pillars. In addition, the pillars must be in physician work contracts, and performance reviews of physicians ought to focus on execution. Healthcare organizations must intentionally take measures to develop the best physician team players having these qualities with each recruitment and performance evaluation. Many health systems significantly undervalue the importance of these processes, and they have had to pay the price.
CONNECT WITH PHYSICIANS AS UNIQUE PEOPLE WITH UNIQUE NEEDS
Health systems must acknowledge physicians as unique people with their perspectives and motivations before alignment can begin. Doctors can interact with health systems in groups and teams, but they should be able to do it individually if they decide to align. Holding staff meetings to convey changes and new guidelines is one of the traditional methods for achieving alignment. Still, most doctors don’t just line up to follow orders and read memos, because they are accustomed to exercising autonomy and making decisions for others in the field.
This means that organizations must put forth the effort to learn what is essential to and motivates individual physicians, bringing their perspectives into the discussion. Also, health system leaders must work with physicians to find solutions rather than go it alone. Physicians must be involved in all clinical, administrative or strategic decisions. Proper alignment entails doctors being free to reject decisions not in their patient’s best interests.
While all of this is evident to doctors, for many health systems, it is a revelation. Physicians’ abilities and inventiveness happen when the environment strengthens rather than diminishes what they do. What little free time doctors have remaining in their schedules is wholly consumed by imposed productivity demands and electronic health record documentation requirements. However, engaging physicians’ enthusiasm by allowing them to investigate, discover and take action on their priorities is crucial for their well-being and a strategy to avoid burnout. According to experts, maintaining energetic alignment requires just 10 to 15 percent of a physician’s time to be set aside for activities like research or learning new skills.
LET THE PHYSICIANS TAKE CHARGE
Leaders of health systems usually are unaware that physicians practice medicine not only to improve patients’ lives directly but also to have a more significant impact by influencing the course of the healthcare organization where they work.
One study focused on three critical medical specialties—cancer, digestive diseases and cardiovascular care—examining the CEOs of the top hundred hospitals in the USNWR. The research focused on whether hospitals perform better when run by qualified medical doctors or non-medical professional managers. According to the report, physician-controlled hospitals have quality ratings around 25 percent higher than those run by managers. This is despite the fact that most doctors have received little to no training in program deployment, finance, operations and executing ideas at scale. So, it may prove beneficial for those in charge of the healthcare system to invest some time in training doctors in the mechanics of implementing change and assisting them while they do so.
Physicians must understand how their actions directly advance the larger objectives of the healthcare system. Doctors need to be aware of what to expect from colleagues, organizational leadership and patients, and what they must do to live up to the expectations of these people. The ultimate result will be a healthcare system that assists doctors in providing better patient care.
Louis Carter is founder and CEO of Most Loved Workplace, Best Practice Institute, Results Based Culture and the author of more than 10 books on best practices in leadership and management, including Change Champion’s Field Guide, In Great Company and Best Practices in Talent Management. He is voted as one of Global Gurus Top 10 Organizational Culture gurus in the world and is one of the top advisers to C-level executives, helping them and their organizations achieve measurable results. His newest book is In Great Company: How to Spark Peak Performance by Creating an Emotionally Connected Workplace (McGraw Hill). He is a partner with Newsweek on the Top 100 Most Loved Workplaces and runs a separate BPI branded entity to provide benchmarking and data insights to Most Loved Workplace companies. His work on leadership philosophies and styles has been used by over 42,000 leaders worldwide. He can be reached at email@example.com.