Health care is inherently complex and continually evolving. Rising pressures on care delivery systems include employee shortages, an older workforce nearing retirement coupled with an aging patient population, rapidly changing finance models, shifting delivery systems focused on value, limited access to behavioral health services—and so many others. All the while, physician employment models are becoming much more prevalent.
Collectively, these issues align to make physician workforce planning and engagement an immediate priority. Emotional equity in the organization grows among all physicians when their peers are seen and engaged as leaders. This equity, in turn, correlates with increases in productivity and referrals, reductions in costs, and improvements in quality. a
Amid the current industry tumult—from both an administrative and a political perspective—organizations have even greater incentive to place physicians in leadership roles. The profession remains among the most trusted by the public, and society continues to view all physicians, at some level, as leaders. Physicians are natural stewards of the clinical delivery enterprise—and the primary managers of health for populations—and thus are best-suited to lead adaptive initiatives, innovative strategies, and novel campaigns designed to improve health care.
In fact, when a physician is the CEO for a delivery system, outcomes on established quality metrics improve between 25 and 33 percent. b Physicians in other leadership roles, meanwhile, can draw from clinical and managerial experience to assist the C-suite in anticipating results of new initiatives. They can gauge how efforts might be perceived and adopted by personnel and patients (generally, physician leaders are very effective at networking in communities).
Another timely argument for physician leadership is the change in priority from disease-focused care and physician-centric business practices to population health management and patient wellness. Leading organizations are engaging physicians and redefining historical relationships to achieve better strategic alignment in pursuit of these goals.
The historical evolution and wide variability of medical staff models, taken together with volume-driven payment, is one dynamic that makes physician engagement a complicated issue. Another involves the traditional stereotypes of expected physician behavior and the tendency of the current medical education system to perpetuate those stereotypes of autonomous, independent decision makers. These factors make it imperative for all to consider different approaches.
Physician engagement and collaboration hinge on having well-educated and well-trained physician leaders. Mentoring and continued professional development are needed at every level and stage of physician leadership development and career progression. In turn, physicians with ambitions of serving in leadership roles must recognize the need to seek additional education and experience.
By working collaboratively, physician leaders and nonclinical leaders build effective relationships that facilitate bidirectional learning.
A Morale-Boosting Approach
Physicians’ knowledge base, level of training, and practical experience command the respect and admiration of colleagues, patients, and the communities and systems in which they serve. Fellow physicians generally see these leaders as peers, thereby establishing a network of support and encouraging physicians throughout the organization to influence outcomes, whether by contributing to organizational care teams, adopting practice reforms, or spearheading improvement initiatives. These physicians themselves may subsequently make the transition from practice to leadership, driving business results, patient satisfaction, wellness, and safety.
With physician demand increasingly outpacing supply, the corresponding rise in employee mobility places organizations at greater risk of turnover. Compensation notwithstanding, physician engagement and leadership promote retention and help physicians feel respected, appreciated, and valued as part of a productive team.
Working together at the organizational level, administrators and physician leaders can lay the foundation for the industry-wide improvements that our patients and their families deserve.
Peter B. Angood, MD, FRCS(C), FACS, MCCM, is CEO and president, American Association for Physician Leadership.
1. Burger, J., and Giger, A., “Want to Increase Hospital Revenues? Engage Your Physicians,” Gallup, June 5, 2014.
2. Goodall, A.H., “Physician-leaders and hospital performance: Is there an association?” Social Science & Medicine, August 2011.