I’m a firm believer that words matter. Specific words deliver specific messages. Sometimes I can be TOO particular and this may be one of those situations, but perhaps not. Engagement, specifically employee engagement and physician engagement, is a hot topic. But with regard to physicians, is it the RIGHT topic?
I used to do a lot of consulting work for hospitals who were trying to “engage” their physicians. More often than not, this would be an orthopedic or cardiovascular service line development effort and we needed to get various groups of physicians actively involved in what we were doing. We needed primary care physicians to refer patients to the program and our specialists. We needed surgeons and other specialists to help in the design and deployment of new, more efficient care delivery models, to take active leadership roles, and to help meet program financial performance goals.
We certainly wanted these physicians to be “engaged” in what we were doing. Similarly, it’s important for a hospital to understand how engaged their medical staff is in what they are trying to accomplish. Accordingly, physician engagement surveys, the data they yield, and the efforts that attempt to improve these scores, have value.
Too often, though, I found that hospital leadership thought that physician “engagement” began and ended with the survey and the relatively esoteric “solutions” that appeased physicians who were unhappy.
The dictionary definition of engagement includes terms like:
Involved in an activity
Having someone’s attention
A leading provider of physician engagement surveys defines engagement as “An individual’s cognitive, emotional, and behavioral connection with an organization’s mission, vision, and values.” At best, these tools measure whether the physician is in some way committed to what the hospital is doing, or at least interested in it. In many respects, it’s a lot like an employee engagement survey and a more engaged workforce is a good thing.
This is a good starting point but real service line success happens when physicians go from being interested, involved, and engaged, to being fully aligned and integrated. In other words, success happens when the success of the hospital and physician are fully linked. Accordingly, I avoided the term physician engagement and, instead, talked about physician-hospital “alignment” and “integration” - if for no other reason than to distinguish our efforts from the those tied to the survey tool.
Engagement sets up the physician as the target of efforts to “get him engaged”, greatly interested, or committed to what the hospital is doing. I found that physicians sometimes don’t want to feel like the target of these engagement efforts. It establishes two separate parties, with one (the hospital), targeting the other (the physicians), as someone to be engaged in its (the hospital’s) efforts toward fulfilling it’s (the hospital’s) goals.
Rather, physicians are looking for a partnership. Even as employees, they recognize that in many ways, they constitute the service the hospital is providing and rather than an employer-employee relationship, they want to feel like they are in a partnership which exists to meet the needs of patients and the community.
So – with a subtle change, we convey the message that we are looking for the two parties to be aligned around common goals and collaborating to achieve those goals.
For instance, we’d go through the very specific step of white-boarding the goals of a group of physicians (employed or independent) to see where those goals are aligned with the hospital’s. Then we’d talk about specific initiatives and ways we can collaborate around those goals. These might include various operational structure changes, leadership structures, clinical integration efforts, business development efforts, or operational changes that can help the physicians to meet their personal and group goals, collaboration on how to best invest in the service line or where cost savings can be realized. These discussions felt a lot more like alignment and collaboration than “engagement”.
It’s a subtle, but important, difference. The survey is a valuable tool to understand how interested or connected the medical staff, as a whole, feels to the hospital. It can also provide data on whether medical staff feels its needs are being met. It does NOT, however, reveal the best way for the hospital to partner with physicians to achieve common goals.
To make this happen, you need to evaluate the degree of alignment of goals – operational goals, performance goals, and career goals. Then you implement a plan that brings those goals, where possible, into alignment and to make concrete strides towards achieving them. I’m pretty sure that if you do this, then “engagement” will take care of itself.