Physician Leadership and Teams: How Do You Get Buy-In?

Physician Leadership and Teams: How Do You Get Buy-In?

I was asked to join Dr. Michael Consuelos (Senior Vice-President at HAP) and Dr. Eric Dobkin (Chief Quality Officer at Crozer-Keystone Health System) to make a few comments about physician leadership and teams at a conference this fall.

Dr. Consuelos started off with the quote by Voltaire, “I know of nothing more laughable than a doctor who does not die of old age.”

Really, if we did indeed have all the answers, we should be the last folks to die of some specific preventable or curable ailment. So we found the discussion around the real life challenges of physician leadership and the issues that occur in the real world of quality folks very enlightening. We should – since we seem to have all the right answers – be able to create teams that work together well and help patients get the best results.

I described the simple steps outlined by Dr. Peter Angood in a FierceHealthcare interview. They were:

  1. obtain buy-in
  2. implement performance measures
  3. offer leadership training
  4. and create a mutual code of conduct

My talk focused on the devilish details of these seemingly simple steps. I learned a lot from other colleagues at the conference. When asked what their greatest challenges were, I got a lot of the same answers. Quality folks tasked with improving quality were challenged with getting physicians to attend and really listen to what they were saying, and commit to some measure of change with the hope of getting improvement.

So, really, it is about change.

How do you engage everyone on the team?

Obtain buy-in. Engage.

This really is about finding out what makes each individual tick. What motivates them?

Some can be brought on board easily – that is a good chunk. They are the leading edge. They are motivated, pay attention and listen. They come to meetings. They “get it.” They adapt to change and want to improve.

There is another chunk of folks who show up but aren’t as on board. They will come to meetings and listen patiently, and go back to their offices and do nothing. Then there are the folks who simply don’t show up.

Like patients who never go to the doctor, we have to identify, tag and track these folks, and engage them individually, because we need their buy-in to succeed in any organizational goal. They can’t be sucked in by “having a meeting” or a command to “read your e-mail.” These are the folks who have to be talked to one on one and individually engaged.

Do you have a trust relationship? Do you know what motivates them? Are they bought in to your goals? Are there ways to make goals align? What makes them tick? Do they feel respected and appreciated?

Data gathering. What’s the problem?

What do you want to work on? Do you have good data on the subject? Is there an identified gap that needs to be corrected or improved? Your non-attender may already have great numbers, and your eager meeting attenders may be the one who need the most work.

Start by saying you found some interesting discrepancies, and ask for help in figuring it out. That’s a better approach than saying, “You’re a low performer,” because you might be wrong and the data is wrong.

Are they motivated to care about your issue? What makes them interested or not? Sometimes comparing them to peers is enough motivation, sometimes you need more. What is the more that you need? Can you give it?

You need to get to know them. Are you doing that? How well? What is your process?

Is the first question “How well are you recognizing these important elements to building physician engagement?”

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