Letter from Our CEO

Allies At Odds: Leveraging Common Ground to Build Physician-Administration Relations

Our recently released Hospital Check-Up Report: Physician Perspectives on American Hospitals gives a mixed review. This report, based on the experiences of nearly 28,000 physicians for the calendar year 2007, reveals that physicians think highly of the quality of patient care being provided and the ease of practicing in their hospitals—two issues that are important to physicians and patients alike. But the greatest opportunity for improvement is physicians’ relationship with hospital leadership.

Physicians identify responding to the ideas and needs of medical staff and communication issues as top areas for improvement. The report examines several domains of physician engagement including responsiveness, ease of practice, agility, trust, and communication. It is striking, though not surprising, that all five of the top priorities deal directly with physician-administration interactions.

"I feel a complete disconnect with the leadership here. Because of my frustration with leadership, I no longer have the energy or time to expend any effort on anything but my own practice."

"I hope that hospital administration will start to involve the medical staff in decisions rather than continue making decisions and then letting us know after the fact."

Perhaps an area of greatest concern to administrators is that surgeons are the least satisfied of all physicians. As surgeons control a disproportionate amount of the revenue stream with their high-value referrals this is sure to get the attention of administrators.

"We should have an 8:00 a.m. ‘cut time.’ We do not. Since complaining has fallen on deaf ears, perhaps the competition of a local surgery center will wake up the OR."

Administrators who are courageous enough to take a closer look at the causes of dissatisfaction and defection among physicians may find the finger pointing squarely at themselves. This, combined with the visibility such data gives the Board of Directors, may cause some administrators to prefer not knowing to allowing the data to speak. Improving physician relations in turn means changing some of their own behaviors that are widening the gap. Such courage often has bottom-line implications.

At Providence Newberg Medical Center in Newberg, Oregon, huge gains in physician satisfaction have led to significant results. Jonathan Emerson, Director of Professional and Support Services notes, "Physicians being satisfied with our facility as a place to practice medicine is wonderful. What else does that do for us? Employees know and the public knows that we compare well to all other hospitals. We tell the community about the high scores we receive from physicians on likelihood to recommend. Our market share has grown as a result, and as a result the employees feel better about where they practice so you don’t have the high turnover rate that many hospitals have." Another benefit Emerson notes is in recruiting new physicians: "When we are recruiting physicians, the very first thing we show them is our medical staff survey results."

As noted in the Hospital Check-Up Report, Sharp Health Care implemented Press Ganey’s physician engagement tool and consulting across the system. Sharp Chula Vista results mirrored national trends. Further examination revealed that physicians disconnected from the administration and from the strategic plans of the organization. With the assistance of their Press Ganey consultant, a newly-formed Physician Satisfaction Committee developed several initiatives to improve communication with physicians (see the link above for the complete report).

Physician-administration alignment is attainable and indeed must be achieved as few issues have a more dramatic impact on patients and on the financial health of a hospital.