Understanding and Responding
to Physician Drivers

Are your physicians skeptical about your organization's commitment to service and operational excellence? It might be because there is leadership variance. In many cases, physicians feel they really work in four hospitals: the day hospital, the night hospital, the weekend hospital, and the holiday hospital. Do quality and efficiency depend on who's working a shift at your organization?

Organizations who want to increase physician engagement need to understand and respond to their four key drivers:
> Quality. Physicians want to know their patients are receiving quality care and very good service.
> Efficiency. A physician can lose 30 minutes a day if the lab, radiology, or surgery departments are inefficient or a nurse is not prepared when calling a physician.
> Input. Ask physicians where they feel the organization should focus to make things run better.
> Appreciation. Physicians value a "thank you" and acknowledgment when things are going well.

“Loyalty is like experience. You can't teach either one. You gain loyalty by increasing physician security through teamwork and communication that results in an optimal practice environment.”
– Floyd D. Loop, M.D., retired CEO, Cleveland Clinic (1989 to 2004) and Studer Group Medical Advisor

Focus, Fix, and Follow Up
The first step in getting physicians on board is to identify physicians who have the most influence on hospital operations (e.g. their role, impact on revenue). Then divide this group into four quadrants, based upon their level of support for change (see, Know Your Physicians”). This allows you to address their unique drivers, fix concerns, and follow up afterwards to capture the win.

"Capturing the wins" refers to all the ways that leaders effectively communicate actions that have been taken based on patient, employee, and physician feedback. Since physicians are trained to focus on the negative variance, CEOs and senior leaders must be especially adept at consistent communication about physician satisfiers they successfully deliver to help physicians remember what's going well.

Imagine, for example, that a physician complains about the number of pressure ulcers. A hospital intent on earning physician loyalty might first review the data to determine if it is indeed a widespread problem (evidence-based leadership). If so, the hospital could ask physicians to participate in teaching modules and then keep a scoreboard in nursing lounges so everyone could measure progress in reducing pressure ulcers. However, many leaders forget one of the most important parts of the process: to follow up and capture the win! Once pressure ulcers have dropped and remained low, continue to communicate these results to physicians.

Tips for Quick Wins with Physicians
> Send thank you notes. Ask each nurse leader or unit nurse to send one hand written thank you note to a physician's home on a regular basis. Physicians who receive such a note typically seek out the nurse who sent it. Let the CEO know who is getting thanked and why so she can extend her appreciation the next time the CEO sees the physician.
> Pass along compliments. to employees on behalf of physicians. Ask physicians "What is going well?" When Dr. Johnson mentions how much he appreciates timely lab results in recent weeks, tell Lucy, the lab manager, "Dr. Johnson wanted you to know how much he appreciates your staff 's on-time lab results over the last month. Please let them know what a difference they are making for physicians."
> Spotlight physicians. who are making a difference at Board meetings. For example, the CEO might say, "Dr. Rivera came in a day off to work with the OR team to develop surgical preference cards for physicians. This has increased efficiency and reduced costs. As the Board chair, I recommend the Board write a letter of appreciation to Dr. Rivera."

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 Adapted from Quint Studer's article "Getting Physicians on Board."