Physician Must-Haves®: What Physicians Want And How To Provide It
by Quint Studer
Adapted from Quint Studer’s book A Culture of High Performance: Achieving Higher Quality at a Lower Cost
What do physicians want? While the particulars vary, creating better places for physicians to practice medicine always requires knowing what they want and providing it. Our experience shows physicians want four basic things: quality, efficiency, input, and appreciation to start. This is the foundation for building a deeper relationship.
The Five Must-Haves for Physicians
To ensure physicians are fully engaged in creating a culture of high performance, Studer Group has identified five "Must-Haves®." These are defined as the tactics, tools, and techniques that need to be implemented in order to achieve the desired outcomes as set by the organization or the leader.
Physician Must Have #1: Involve Physicians in Goal Setting
Physicians are data-driven. Yet, research shows they have not typically received data about individual performance, clinical outcomes or patient survey data.1 Now they suddenly have access to data points (e.g., Core Measures, HCAHPS, CG CAHPS, Physician Quality Reporting System), but the data is often not timely or actionable for them to use.
We find that physicians make excellent partners in moving organizational performance around these crucial metrics when they understand why the data is relevant; goals are well-aligned and cascaded; and there are a manageable number of metrics. Then physicians really "get" it. In turn, health systems know that physicians are key players in ensuring patients move quickly through the system (reducing cost per adjusted discharge and increasing capacity). This also helps physicians align with organizational goals.
Physician Must Have #2: Round on Physicians
This tactic is integral to providing physicians with a place where it is satisfying to practice medicine. Rounding for outcomes with the physician is more than having a relationship; it's having a relationship that leads to higher physician engagement. It also addresses the lowest rated area in physician satisfaction surveys: administrative responsiveness.
Frequency is vital. Our data finds that if physicians are rounded on once a month using the prescribed model of rounding, physician engagement will be in the top 15 percent and many times in the top 10 percent. If physicians are rounded on once per quarter, physician engagement will be in the top 25 percent. If physicians are rounded on every six months, only once a year or never, their engagement is typically 50 percent or lower.
OU Physicians, Oklahoma's largest physician group, with 830 credential providers in 63 clinic locations, uses a robust process where CEO Brian Maddy and CMO Lynn Mitchell, MD, MPH round together on their three "core medical directors" for primary care, adult clinics, and pediatric clinics. Rounding is then cascaded down to front-line physicians with wins and challenges captured in rounding logs. Items that need fixing are rolled up into a stoplight report that is posted, shared widely at meetings and on OU Physicians' intranet so everyone is current on the status of what they reported. Since FY 2008, their team has moved patient satisfaction from the 8th to the 78th percentile. Net revenue is also up 47 percent over the same period.
Physician Must Have #3: Focus, Fix, and Follow Up
When rounding, one way to address administrative responsiveness is through Focus, Fix and Follow up. When a physician has a concern or complaint, document any issues that are raised, address them, and communicate back to the physicians what you did to solve the issue.
To take Focus, Fix, and Follow-up to the next level, begin by identifying physicians who have the most influence on hospital operations (e.g., through their role, impact on revenue). Then divide them into four quadrants based on support for change so you can focus on their unique drivers to maximize impact. (To learn more, visit www.studergroup.com/FocusFix).
Physician Must Have #4: AIDET®
AIDET® is an acronym that represents the five fundamentals of patient communication (Acknowledge-Introduce-Duration-Explanation-Thank You). When employees are skilled in AIDET, the physician-employee interactions become more effective, resulting in higher organizational performance.
When physicians use this tactic, it reduces patient anxiety and increases patient compliance. Helping physicians learn how to use AIDET has a dramatic positive impact on both clinical outcomes and the patient experience while also aligning physician behaviors with employees who use AIDET. (Studer Group partners can visit our Learning Lab at www.studergroup.com/AIDETtips to watch a short video on AIDET® for Providers.)
Physician Must Have #5: Reward and Recognize
It is easy to think that because of the nature of a physician's work that they don't need reward and recognition...that the value and the impact they have goes without saying. However, this is not true. Don't underestimate the importance of reward and recognition to a physician. I can think of dozens and dozens of times where a heartfelt thank you note forged an important bond, retained a physician who was thinking about leaving, or earned important trust and confidence in shared values. Express your genuine, specific appreciation and I guarantee you'll make a physician's day (and if you include their staff it's a double win).
All of us who work in healthcare—no matter what our employment status is, where we are, or what we do—are a part of "the great patient care team." We need to create operational frameworks that allow all members of our team (including physicians) to execute in a way that truly hardwires excellence. The Physician Satisfiers outlined below remind us what physician's want. The Must Haves make it all come together.
||Physicians want to know their patients are receiving quality care and a great patient experience. They also want to reduce the time it takes to follow-up and address patient and family complaints.
||Physicians want to work with team members who have the information needed to discuss their patients at hand. Over the course of a day, this efficiency will save the physicians 30 minutes or more.
||Physicians need a seat at the table to provide input when decisions are being made that affect clinical outcomes. Round on physicians and consistently ask them, “Do you have everything you need to provide excellent care to your patient?” Also, meet with hospitalists each month as they operate with physicians on a daily basis.
||Physicians value a “thank you” and acknowledgement when things are going well. They also want to see follow-through on their input in the form of tangible actions.
Source: Physician Satisfiers – January 2001, Journal of the American Medical Association