Helping Physicians Thrive: A Call to Action for the Healthcare C-Suite
Tom Jackiewicz, President of University of Chicago Medical Center, COO of UChicago Medicine
My last LinkedIn article addressed the importance of involving physicians in transformational change. I emphasized the need to redouble efforts to support physicians, elevate physician leaders, and keep physicians at the forefront of major initiatives.
What I didn’t discuss is the commitment those of us in the C-Suite must make to create an environment and culture where physicians can thrive. For decades, we’ve been talking about the need to improve physician-hospital relationships. While discussion is a step in the right direction, the truth is that we, as an industry, should have made more progress by now.
There’s room for finger-pointing on both sides, but it’s way past time to move on from that. We in the C-suite need to take a hard look at what’s within our control to change, where we can have the greatest impact, and where the best chance for executing change exists.
Many of the changes needed to work more effectively with physicians are tied to culture. The “culture eats strategy for lunch” thought bubble instantly appears for most of us when the culture topic surfaces. That’s because it rings true in most situations. The good news about cultural change is that it is often low cost or free. Instead of a financial commitment, it requires us to be better leaders. It requires that we slow down and listen, put ourselves in someone else’s shoes, and model the change we want to see.
Working well with physicians is a skill I’ve tried to refine during my career. I have the added advantage of being married to a physician. My wife, Dr. Carol Peden, deserves a lot of credit for improvements I’ve made. One area she has coached me on is engaging physicians in what they care about.
For example, an improvement project enthusiastically crafted behind the scenes is presented to physicians and receives a neutral or negative reaction. The oversimplified conclusion is that physicians don’t care about improvement. But when the layers are stripped back, that’s usually not the case.
The key to physician engagement is identifying and understanding what they care about. That means frequent open and honest dialogue, especially about improvement initiatives. That means involving physicians early and often, not presenting them with a fully baked initiative and then asking for input. That also means being clear about the why. Physicians want to understand the purpose and strategy behind change initiatives and the benefit their patients will experience because of those changes.
If opportunities to provide better patient care are lost in talk about cost benefits and the importance of standardization, physician engagement will take a hit. Physicians also want data. Anecdotal observations about what physicians should do differently won’t suffice. Executives must know the data and be ready for questions.
Beyond nurturing physician engagement, we, as leaders, must do so much more.
Hire the best and get out of the way. When I led the creation of an academic health system start-up for the University of Southern California, we devoted significant effort to recruiting a strong and diverse team of department chairs and physician leaders. Then, we let them do the work they were recruited to do. That meant giving them space to be creative and find areas where there was need and opportunity to grow. We let them recruit the right people to drive that growth, and then helped ensure that those physicians were given opportunities to put their imprint on something. Even attendings had opportunities to engage with hospital leadership and help drive change, such as designing a new service. Find the early adopters and physicians who are highly regarded by their peers absent age and experience. Then get out of their way!
Provide opportunities for physicians to learn. By the time most administrative leaders make it to the C-suite, they have participated in or led quality improvement initiatives. Not so for physicians, whose careers may have bypassed involvement in quality efforts. With learning opportunities and coaching, physicians can become engaged change agents. Physicians who learn how to improve the care they provide and influence the environment they work in often find they are able to reconnect with why they became physicians. To accomplish that, executives can’t overlook or dismiss the need for educational programs.
Create room to fail. I’ve worked for six academic health systems during my career. True change is not enacted without some level of failure, especially when change is fast paced and transformational. The key is to create space for a soft landing when physician initiatives falter, assess the failure, and then move on to new solutions without excessive ruminating.
Grow from difficulties. Challenges or crises can break organizations or galvanize them. Recruiters will arrive upon the mere whiff of difficulty. Without swift action to promote healing, damage can spread quickly. If we are engaged as leaders, as we expect our physicians to be, we will get in front of difficulties, learn from them, and use them to build organizational resilience.
Part ways when necessary. There are circumstances where parting ways with physicians is the right choice. If physicians refuse to engage on key quality and efficiency initiatives or sabotage these efforts to preserve the status quo, their interests cannot be prioritized over the greater good being pursued by a group of physicians working on behalf of their patients.
Deliver on your promises. Promises of leadership support, resources, accessibility, and other things of value put your credibility and reputation on the line. As executives, we should know by this point in our careers to not make promises lightly, but reminders may be needed to not cavalierly throw around commitments we cannot or should not keep. People will remember your words and only trust you once they see action.
C-suite colleagues – any other words of wisdom that should be shared as we recommit to creating organizations where physicians can thrive?