It is my privilege as HealthTrust’s chief medical officer to write this first edition of what will be a recurring column for The Source. My contributions will serve as a way to keep the membership updated on HealthTrust’s evolving clinical agenda and capabilities, discuss product and technology advances that impact the way providers care for their patients, and report on how the evolving partnership between practicing physicians and hospitals is changing the way we view devices and their utilization.
One of my primary goals as CMO is to expand opportunities for physician engagement in purchasing and device utilization decisions. As the healthcare system continues to evolve around us, and as greater emphasis is placed on value and quality over volume in care delivery, the need to understand the value of the products we contract for and use has never been more important. This means a greater emphasis on evidence-based medicine and data and analytics to drive our purchasing decisions. Data and published evidence on their own, however, will not provide us with all the answers. We must turn data into knowledge and then apply that knowledge to everyday practice. To do this, engaging in the conversation those who provide care on the front lines is critical. It is only the combination of the right data with the right clinical expertise that results in delivering the highest value care to our patients.
So while the evolution of the healthcare system has created both the need and the opportunity to partner with physicians and other providers to better understand products and utilization, the challenges around that type of engagement still exist. Historic barriers between physicians and administrators linger, fueled by outdated assumptions that each group harbors different motives or goals. The goal of a successful physician engagement strategy is to break down these barriers and create a high-functioning clinical team, made up of both practicing providers and administrators who are working toward common goals. How can this be accomplished? Observing, participating and building these teams has led me to three basic concepts that are critical to a successful engagement strategy: goal alignment, physician voice and transparency.
1. Goal Alignment
One pitfall that often stalls attempts at physician engagement is choosing the wrong goals. For example, if you were looking to engage physicians around supply utilization, having a team goal of “reducing supply costs per adjusted admission,” or “limiting the number of suppliers in a physician preference category”—neither is likely to resonate with physicians on the team and more than likely will stall the conversation before it even begins. While research suggests that unnecessary variance in surgical approach or device utilization leads to lower quality care, the physicians involved in that care believe in the choices they are making and their role in making such selections. Finding common ground and choosing goals that all members of the team believe in will lead to the type of engagement that can truly drive meaningful change. Refocusing a supply utilization engagement strategy around “delivering the highest value care to patients” will resonate with all team members.
2. Voice
When physicians are questioned about what they are looking for from their hospital or health system, frequently one of the top responses is that they “want to be involved in strategic decisions.” Giving physicians meaningful voice in a decision-making process is a great way to develop trust. This supports not only the current engagement, but also a longer-term relationship that will see both parties finding ways to make each other successful. For voice to be effective, it must be legitimate. Respecting physician input and honoring the decisions they help make is what will create that trusting relationship.
3. Transparency
Demonstrating that we are all now working toward a common goal—high-value patient care—transparency is the most powerful tool in breaking down the perceived barriers between physicians and administrators. Transparency is also critical to developing trust; being transparent around topics that have been perceived in the past as sensitive (e.g., the true cost of devices, margins on procedures) will break down those barriers and help foster teamwork. Transparency is also critical to successful partnerships because it is only when all members of the team are working from the same information that the right outcomes will be reached. Data transparency also creates additional value for physicians in partnering with their hospital or system. More than ever, physicians are looking for partners that can help them understand what good looks like and how it can be achieved.
It is only when all three of these concepts—goal alignment, voice and transparency—coexist and intersect that successful, high functioning teams will emerge for the long term.
I am often asked how the approach to engagement differs between employed versus independent physicians. The short answer is: It doesn’t. Employment contracts are more about where a physician practices, not how they practice. If you are looking to create efficiencies in the way medicine is practiced, look past the contracts. Finding ways to be transparent, giving physicians real voice and input, and finding common goals to work toward is what will lead to meaningful improvements in the value of the care you deliver.
Michael Schlosser, M.D., FAANS
Chief Medical Officer, HealthTrust
Share Email
