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Communication to Keep Physicians in the Loop
Author: Kriss Barlow, RN, MBA
This article has been updated by the author to reflect 2009 trends and market dynamics.
For almost every healthcare executive, managing change seems to be a daily obligation. Change means that people and departments are in a state of flux. What is all of this change doing to impact communication? Tremendous energy is being spent to inform all the key players internally. No one wants to be left out of the loop, so emails follow a chain of command and the line of cc's and FYI notes abound. With this heavy inward focus, are we at risk of failing to give proper time and attention to our messages to patients, employers and physicians? It is not just about willingness to share, it is the art of thoughtful communication that has the potential to become secondary because we are managing internal politics, determining ROI or reducing costs and working through the issues of budget.
The World of Physicians
While all of these audiences are important, the one that is near and dear to my heart is the physicians. For the medical staff, the current wave of changes and communication challenges come at a time when hospital trust is already shaky. Many physicians believe that hospitals lack understanding of and support for their issues. The recent MGMA study showed that again in 2008, expenses in the practice rose at a faster pace than revenue. They are paying more for their drugs, malpractice and staffing and the fees are just keeping pace.
That physicians and hospitals get along well is widely assumed by the public—and broadly denied by insiders. Although a new model of strategy is unlikely to transform decades of assumptions on both sides; planned communication make sense in any regard. In most markets, physicians guide much of the referral business. It is the physician who keeps the hospital inpatient and outpatient services full. Hospitals need to proactively develop a plan to regain credibility and ensure strong working relationships. The hospital and physician together can then focus on what is good for medicine, and what is good for the patient. Without a doubt, keeping physicians involved and supportive of the organization is the right thing to do. So, what needs be in place to ensure a working communication approach with physicians?
Test the Current Climate
Health system leaders assume their employees understand that because physicians bring in referrals and are necessary for the organization's financial survival, the team—doctors and staff—work together. Don't assume that everyone considers nurturing, maintaining or developing physician relationships is part of their job.
- Start with a look at the organizations overall approach with physicians. Assess what is in place. Detail what you have, how the elements are coordinated and how many physicians you are reaching with it.
- Evaluate physician relationships, communication approach, methods of involvement, measures of effectiveness and the skill sets of the responsible staff.
- Analyze referral data; determine the level of dependence on a specific physician or group. Look at revenue and volume numbers by physician, group and specialty. For many organizations, these numbers are often sobering; a few physicians are responsible for a very large percentage of the hospital's revenue.
- Research who is communicating with your specialists- and with those who "feed" them referrals. How does information get to the primary care practice? Analyze primary care referral data and support this through candid discussions with the specialists.
Assess the data fully; evaluate the current process, detail the competitive vulnerabilities as it relates to physician connections and focus on your communication opportunities. If your analysis indicates a need to re-tool, then start by creating a thoughtful model that relies on the data to determine the effort, the method of communication and the measure of success.
Communication with the Medical Staff
The assumption is that because physicians are "in the building" every day, they have their finger on the inner workings of the organization. That is really pretty questionable. In addition, for many of today's physicians, hospital work is limited and when there, less time is committed to conversation or any social connections. Add to that past hospital expectations that if updates and information are printed in physician communications materials, the medical staff will read and remember the details and respond appropriately.
Communication seems to be a chronic problem. People are distracted and often do not hear important messages. Communication is an issue for everyone, not just marketing or the CEO, but all system members across the continuum. Set physician communication as a priority and measure the impact. There is no single perfect approach for getting your message to physicians; a mix of communication strategies must be employed to ensure a consistent flow of information. It all starts when there is agreement that it is important to include physicians in the communication plan and when everyone is accountable.
Physician Communication Ideas
- Get people talking. Beyond the usual approach of telling the physicians what the hospital has to offer, communication should include opportunities for dialogue.
- Get physicians involved by soliciting their input and then showing them how their input is used.
- Ask physician representatives to share targeted messages and solicit feedback as a part of their regular visits.
- Have leader's do the same for their key stakeholder physicians.
- Determine regular checkpoints for soliciting feedback - not just from the chief or department directors, but also from a variety of members of the medical staff.
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Again, the physician representative can be an ally. Every physician who receives a face-to-face visit can be asked the same question. Over time, trends will become apparent. The advantage is that every targeted physician responds rather than just those who can be reached by traditional survey methods.
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Make an effort to call other physicians who might be impacted by your initiative. Offer information, tell them how you will use their opinions and make sure to give them a first look.
- Conduct small task force meetings - six physicians attending two to three meetings can be a very effective format for soliciting feedback and input.
The task force meetings should have a very focused structure - their job is not to develop copy or determine how customer service issues should be addressed, but to identify the areas where their understanding, buy-in and communication with colleagues is beneficial.
- See things from physicians' perspective.
Consider how physicians would respond if they are not made aware of changes. Listen carefully in the dialogue-based meetings. There will be good indicators of physician red flags, issues that are priorities for them and their main concerns when communicating with others.
- Provide a conduit for information and messages regarding hospital happenings, educational opportunities, referral source follow-up, and appointment challenges, all prime areas for hospital-physician dialogue.
Growing the Relationship and Growing the Business
Leaders are interested in finding additional ways to "connect" with physicians. Communication strategy should be front and center. Through a physician relations/ liaison approach, there is opportunity to use face-to-face dialogue as a tool. Through marketing, information can be offered in a style and approach that has value for the doctor and helps extend the hospital's message. The real value comes when all parties are aligned in their desire to include the physician in their communication plan.