Why physician engagement is the key to better health care and how to improve it

By Nicole Sully, DO, Primary Care, Family Medicine

“Engage” has become a buzzword in 21^st century communications. It’s one of those all-encompassing words that as a verb elicits synonyms such as attract, involve, interlock, and hold the attention of, among others. As an adjective, it has become perhaps the most important word in the language when describing parents, employees, and especially doctors. In this respect, engaged means “to be committed to or supportive of a cause.”

Based on this definition, it’s not difficult to understand that patients, hospitals, peers, and health care leaders would prefer engaged physicians over those who are not engaged in their work.

The ripple effect of commitment to quality

Patients can tell immediately whether their doctor is listening and if they truly care about their condition or situation. For health care leaders and hospitals, focusing on engagement is a matter of quality and also profitability, as caring, committed physicians turn out to be much more productive than their less involved counterparts. In a 2015 Gallup® study at one hospital system, physicians rated as “engaged” or “fully engaged” delivered an average of 51 percent more inpatient referrals than those who were not engaged. Results of the study showed that the most engaged physicians were 26 percent more productive than the others, and each one accounted for an average of $460,000 more in patient revenue per year.

Building on this idea, engagement has been shown to contribute to overall organizational performance. For that reason, it becomes vital as the very structure of health care undergoes a dramatic evolution. Physician performance is increasingly tied to reimbursement from payers. Physicians who are engaged in their work are more resilient and determined when it comes to change and can be the make-or-break factor in a health care system’s quality of care and value for patients.

Getting to the heart of disengagement

Lots of attention in the last few years has been directed to physician burnout, or as some would prefer to characterize “moral injury.” Provider health is at risk across the country as clinicians express frustration with administrative overload, lack of autonomy, and reduced interaction with patients and peers. This kind of frustration has impacted physician engagement.

Now that physician well-being has surfaced as a concern, conscientious leaders at health care systems and PHOs are working on ways to mitigate the problem. While moral injury is not the only cause underlying disengagement, it certainly is a major contributor. According to Gallup®, the following four elements have been identified as critical factors of physician engagement. As you can see, they incorporate many of the same issues that have caused clinicians to feel burned out while practicing medicine today.

• Personal well-being: Focuses on work/life balance and programs that can promote healthy living
• Communication and support: Relates to communication across the system, and getting the staffing support physicians need
• Scheduling and workload: Time available for clinical practice and research, as well as having control over their own schedules
• Involvement with leadership: Speaks to whether physicians feel they play a part in decision-making related to clinical and administrative policies

The drive potential of data and incentives

In any conversation about turning the tide on physician disengagement, two factors rise to the top. The first is data. At the core, physicians are scientists and always appreciate seeing the data behind a decision or why leadership may be making a certain request. There is also power in the numbers related to a physician’s performance, particularly when comparing the results with that of their peers. This information is available through the kind of advanced health care analytics available today.

Delivering insightful data directly to providers can have a highly motivating effect, since the data can be used to track patient outcomes and performance with the payers. This is why organizations who are more successful at increasing physician engagement are working together with an analytics provider to keep physicians informed about their performance metrics, their patient outcomes, their episode costs, and overall trends.

Another powerful weapon for stimulating engagement is financial incentives. This is not just a bonus. Effective incentives are structured in a way that aligns with an organization’s overall goals for cost-effective care and quality outcomes. Such programs should start with clearly defined, measurable, and trackable (analytics again) metrics. To encourage the switch to value-based incentives, the metrics should be aligned with value based contracts. Appropriately, higher performing providers should earn higher rewards.

What does a successful model of physician engagement look like?

Like all successful organizational endeavors, a physician engagement strategy starts at the top – with CEOs, presidents, and leaders – who understand the importance of the physician’s voice as part of the structure of the organization. From there, a hospital or PHO needs to have strong leadership: not just clinical individuals, but those who can pool their collective knowledge in the areas of health care finance, population health strategies, quality management, and health care technology. These leaders should be onboard with creating opportunities for physicians, so they can contribute and feel as though they are valued. By including physicians’ ideas and addressing their concerns, the physicians will regain the autonomy they yearn for, thus hopefully making them more productive in their work.

Providing educational opportunities for physicians and allowing them to express their point of view are priorities as well. Staying abreast of organizational policies, changes driving the industry, and medical news enables physicians to be more effective providers. Avoiding sterile meetings and instead opting for interactive sessions allows physicians to express their thoughts and offer input. To this, add the motivation of a structured incentive program and the insight provided by analytics data and you have the basic components of a good physician engagement strategy.

The ability to envision and implement this is more important now than ever. Experts contend that the organizations who are likely to succeed in a fee-for-value health care system are those who have prioritized this issue and placed time, energy, and effort into the engagement and well-being of their physicians.