HEALTHCARE HIRING PERSPECTIVES BLOG

How Personality Impacts Physician Success, Burnout, and Disruptive Behavior

Posted by  Bryan Warren

In recent weeks, I’ve been back in the world of physician-hospital alignment, speaking on the topic at a recent conference and preparing to moderate a local American College of Healthcare Executives panel on hospital-medical staff relations.

In these discussions several topics come up over and over:

  1. We are asking physicians to lead but are we preparing them to lead effectively?

  2. Why are so many physicians dissatisfied?

  3. Why are health systems struggling to engage the medical staff in important initiatives?

  4. What can we do about physician burnout?

We could talk for hours on each of these topics, but let me give a few brief thoughts on each.

We are asking physicians to lead but are we preparing them to lead effectively?

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No. It’s that simple. It’s better than it was. Most larger systems now have formal programs in place to help physicians to understand new leadership expectations and to develop leadership skills.

In their training, physicians learn to lead the care team – sometimes effectively, sometimes not. More often than not it’s an authoritarian leadership style which can work in these settings, because it doesn’t require much deep insight into leadership style; it’s the expected leadership style and, to be honest, some care settings lend themselves to this approach. But then we put physicians in a room of leaders from other fields and departments and ask them to solve complex problems. A traditional leadership style doesn’t work here. This setting requires the ability to negotiate, a high level of emotional intelligence, business acumen, the ability to think strategically, to collaborate, to delegate, to plan and organize, and on and on. Few of these skills are required to be a solid clinician.

Kudos to those organizations with visionary physician leaders and deep training and development resources. Medical schools need to do a better job, though, of exposing students to what it means to lead. Many times, physicians merely adopt the leadership style they are exposed to as residents or fellows, whether it's effective or not. We need to identify physicians with leadership potential and develop that potential. We need to do this QUICKLY. The problems are here today. We need effective physician leaders tomorrow, at the latest.

Related: Three Keys to Developing Physician Leaders

One of the things we’ve been doing is applying the tools used for other leadership roles to physicians. Most are incredibly receptive to understanding how they can modify their behaviors to be more effective. They are driven, want to succeed, and are looking for help.

Why are physicians so dissatisfied?

You can’t blame all of this on electronic health records, but that’s part of it. We’ve deemphasized the things that provide physicians their greatest satisfaction and spend all of our time asking them to do things they don’t enjoy and probably aren’t well suited for. We can’t deny that the practice of medicine has changed and it’s not going back. It’s not the first profession to change.

But it might be the first that seems to ignore these changes when we think about preparing people to succeed. We’ve not sufficiently explored these changes and what is required for success today. Being a solid clinician is the foundation for success and satisfaction. Navigating the challenges of medicine today requires emotional intelligence, time management skills, planning and organizing skills, adaptability, and innovation.

Related: Emotional Intelligence - A Conversation with a Physician Leader

Similarly, organizations spend their time and resources attracting and recruiting physicians but spend a fraction of those resources helping physicians to succeed. Surveys show that physicians are frequently unhappy, not about EHR systems (although that adds to the frustration) or pay, but a feeling that their goals and expectations simply aren’t aligned with those of their employer. How does that happen? It doesn’t happen in most professional roles. Quite simply, the employer here doesn’t know (and sometimes doesn’t care) what the physician needs to be successful or understand his career goals. Similarly, physicians often take a position without really understanding their own goals or what they need to be successful. Physicians are incredibly valuable and expensive resources. Each one should come into his or her role with a plan for success.

I had this discussion with a hospital administrator who acknowledged that this approach makes sense but he questioned where he’d get the resources to do it. How about the service line administrator? You own orthopedics? Then you should own working with each surgeon to develop a plan for growth and success. We were talking about a surgeon who generates $40,000 with two surgical cases. We can’t find resources to make her successful? If she leaves, it costs $1 million. Do the math.

Related: The Shocking Cost of Physician Turnover

One of our clients uses a physician-specific behavioral assessment to better understand physicians joining the system. They even use the information gleaned from this tool and the interview to decide how to position each physician for success.

Why are health systems struggling to engage the medical staff in important initiatives?

There are lots of reasons but a big one is the overall hospital approach. Physicians see these initiatives as system initiatives that need physicians to be engaged if they want to succeed. They feel like targets of the system’s engagement efforts. Start by engaging them in deciding what the goals are in the first place. Show them how the respective goals are aligned. Let them help to define the initiative – look for alignment, not just engagement.

This requires work to really understand the needs and goals of individual physicians to decide the best way to align goals and get them engaged. Again, a perfect task for the individual service line administrator.

Related: Four Steps to Engage Employed Physicians

I'm reminded of a project where the CEO wanted to know why the orthopedic program wasn’t growing. Why the surgeons weren’t engaged in his growth initiative. Simply interviewing the surgeons revealed that none of them were interested in growing their own surgical volume. If 10 surgeons desire 0% growth in their individual volume, the math doesn’t work for the CEO’s projected 20% volume growth.

What can we do about physician burnout?

A client asked us if we could build a personality test that would identify physicians most susceptible to burn-out. Personality has a role. There is research showing that people with higher levels of stress tolerance (obviously) and emotional intelligence are better able to navigate challenging situations.

The physician with high levels of these two attributes may fend off burnout longer than another physician but what good is it if they burnout in two years, rather than six months?? Burnout is less a product of personality than of the work environment itself.

What use is it for us to tell them how physicians score in these two areas? We can’t change their personality. At best, they could learn coping mechanisms.

For a time, disruptive behavior was the hot topic. Certainly, disruptive physicians are a problem, but in my experience some physicians labeled as disruptive were actually just physicians who were acting out after years of valid frustration. They act out and are labeled disruptive or become withdrawn and are identified as suffering from burnout. There are plenty of programs to try and remedy either situation – but why not prevent it in the first place???

Understand each physician’s personality, strengths, and weaknesses. Understand their goals. Coach them on reasonable goals. Find where the goals align with the system’s goals and where they don’t. Make sure it’s a good fit in the first place. Work with them on a plan to help them achieve THEIR goals, not just yours. Would you invest $500k in an executive whose goals weren’t aligned with yours or simply fail to even find out? Or find out and just ignore it and hope she stays and is somehow effective?

Learn more:

employed-physicians

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Tags:   physician leaders, employee engagement, physician turnover, turnover, healthcare hiring, physician-hospital alignment, physician hiring strategies

Bryan Warren

Bryan is the former Director of Healthcare Solutions at Select International. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.

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