USE STANDARDS OF CONDUCT:
It's the Right Thing to Do
The first six tools in this issue of Hardwired Results are designed to help hospitals provide better service to physicians. In our experience, hospitals that serve physicians well create loyal physicians who manage up nurses; submit excellent ideas for operational improvement; and reward and recognize high performing staff. When they see what a difference standards of conduct make for employees, they even create their own standards.
Increasingly, First Mover organizations recognize that aligning physician behaviors with those of employees is key to realizing the organizational vision. Patient satisfaction is greatly impacted by a physician's attitude, courtesy, and communication skills.
Even the Wall Street Journal noted in a September 2004 article that "People place more importance on doctors' interpersonal skills than their medical judgment or experience…doctors' failings in these areas are the overwhelming factor that drives patients to switch doctors."
Equally important, physicians set the pace, tone, and standard of each work unit. And so, just as health care organizations are requiring employees to sign organizational behavior standards as a condition of employment, physicians are increasingly being asked to sign standards of conduct as a condition of practicing medicine.
What's Included
Every organization does it differently. Some organizations ask physicians to sign the same standards their employees follow. Others use professional standards based on provisions of the medical staff bylaws, rules and regulations. And some are very prescriptive and specific to physicians.
"Our standards were created by physicians for physicians," explains Dr. Stephen Beeson of Sharp Rees-Stealy Medical Group (affiliated with Sharp HealthCare in San Diego, CA) who recently rolled out the standards to the group's 700 physicians. "Physicians were asked to sign a pledge that says they commit to promote a positive workplace environment for staff and fellow physicians through specific behaviors."
When they sign the pledge, Sharp Rees- Stealy physicians agree to return patient phone calls and pages promptly; work cooperatively with staff and nurses; submit charges for services provided in a timely fashion; and communicate in a respectful way among other things.
An accompanying "Physician Code" expresses Sharp Rees-Stealy Medical Group's vision of what excellent physician leadership looks like and why it is important: to offer quality services that set community standards and exceed expectations in a caring, convenient, affordable, and accessible manner.
The code explains that the medical group seeks to create ideals that define the type of physician who works there and to provide an atmosphere where physicians flourish professionally and personally. Having connected to purpose, the code then details expected physician behaviors with respect to staff, physician colleagues, and patients.
Increasingly, organizations find that leading by example is not just one way to influence others. It is the only way. To nurture physician leadership within the organization, Sharp Rees-Stealy profiles physicians who demonstrate exceptional achievement in its Pillar areas (people, service, quality, finance, growth and community). The medical group also shares these physician stories widely and confers a $1000 prize with Pillar awards.
What about Physicians Who Won't Sign?
"It's an honor code that describes the type of physician who works for us," explains Beeson. "If a physician doesn't want to sign, it will be noted in his or her medical staff file, but over time I think the few physicians who may not sign will become isolated from the large majority of high performers who will embrace the vision."
"The task of medicine…Cure sometimes, relieve often, and comfort always."
— Ambroise Pare, 16th century surgeon
"Physicians are no different than anyone else," adds Dr. Loren Meyer of All Saints Healthcare in Racine, WI. "We expect them to treat everyone with respect and dignity. I find that those who already do so don't have a problem signing standards." All Saints routinely takes action with non-compliant physicians, even removing an exclusive contract for clinical services in one case. Employed physicians are awarded incentive compensation based on patient satisfaction and peer/staff feedback.
Sample Physician Pledge
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As a Sharp Rees-Stealy physician I will: |
► Return patient phone calls on the day the call was received. |
► Return pages in a timely fashion. |
► Work cooperatively with staff and nurses at the hospital, call center, Nurse Connection, home health, hospice, and ancillary agencies. |
► Arrive to work on time. |
► Submit charges for services provided without delay. |
► Interact and communicate with physician colleagues, administration and staff in a respectful, cooperative and positive manner. |
► Perform in a manner which fosters patient satisfaction and loyalty to the medical group. |
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