Achieving Optimal Physician Engagement

Coach’s Corner
CSPE Newsletter

Take a moment to consider how physicians in your healthcare organization are feeling.  Do they come to work each day with passion and purpose?  Do they feel appreciated and valued?  Do they have a sense of commitment?  Do they believe that what they are doing is important?  Do they give work their ‘all’ each day?  Do you feel they are always on board when you launch cost-saving or quality improvement measures?  If you answered ‘No’ to even one of these questions, there is work to be done.  Creating a culture of excellence in which physicians feel fully engaged in their work is necessary, and can ultimately lead to increased physician and patient satisfaction, impact loyalty, and create trust.

Physician satisfaction surveys across the country are indicating that physicians do not feel satisfied at work, feel unappreciated, and do not feel that they have a positive or effective relationship with their healthcare institutions and managers.  Many physician executives will acknowledge that achieving physician engagement is a key area of concern for them. 

Physicians are busier than ever.  In their attempts to manage time, it is understandable that they focus more on patient care than organizational goals, and can even be resistant to adopting new changes. Yet, without their attention and support, many organizational initiatives cannot succeed. 

What is physician engagement? While there is little written on this in the medical literature, the business world has been focusing on this for some time, as it has been clearly shown that companies with high employee engagement had less turnover and remarkably higher percentages of customer loyalty, profitability, and revenues. Kahn, in 1990, described engagement at work as “the harnessing of organizational members’ selves to their work roles”.  When engaged, he showed how people connected to their work and workplace in three aspects – physically, cognitively, and emotionally.

In medicine, physician engagement is the level of commitment and involvement that the physician has towards the healthcare organization and its values.  This is a positive attitude that allows them to work alone and with colleagues to improve performance at work for the benefit of the organization.  The engaged physician wants to be committed because doing so satisfies a powerful and basic need to connect with and contribute to something of significance.   There are three aspects of physician engagement:

1. the physicians, and their unique psychological characteristics, expectations, experience
2. the workplace and its managers, and their ability to create the conditions, culture, and environment that promote physician engagement
3. the interaction between physicians, colleagues, and managers

Engaged physicians are ‘builders’.  They are naturally curious.  They want to use their strengths at work every day.  They want to perform at their best consistently.  They want to know the expectations of their roles, so that they can meet and exceed them. They want to provide the best patient care.  They want their healthcare organization to be innovative, forward-thinking, and succeed.

It is the responsibility of the healthcare organization and the managers to manage engagement, and to create the optimal environment to promote engagement by the physicians and achieve consistently high performance levels.

Managers need to understand the critical factors that lead to engagement, and to ensure they are present.   Regular measurement of engagement is essential to track its contribution to the success of the organization.  The Gallup Organization, conducted hundreds of focus groups and thousands of interviews to create the Gallup Q12, a twelve question survey that identifies strong feelings of feelings of employee engagement.  These questions ask:

1. Do you know what is expected of you at work?
2. Do you have the materials and equipment you need to do your work right?
3. At work, do you have the opportunity to do what you do best every day?
4. In the last seven days, have you received recognition or praise for doing good work?
5. Does your supervisor, or someone at work, seem to care about you as a person?
6. Is there someone at work who encourages your development?
7. At work, do your opinions seem to count?
8. Does the mission/purpose of your company make you feel your job is important?
9. Are your fellow colleagues committed to doing quality work?
10. Do you have a best friend at work?
11. In the last six months, has someone talked to you about your progress?
12. In the last year, have you had opportunities at work to learn and grow?

This survey measures engagement, a positive emotional connection to work and the workplace.  It emphasizes the importance of communication, and recognition.

Based on this, I offer a ten-point physician engagement strategy:

1. Clear and regular communication about  what is expected from each physician, how their success is defined, and outline the part they play in the overall success of the healthcare organization
2. Making sure they have what they need to do their work properly
3. Ensuring their role reflects their strengths, training, interests, and career goals
4. Rewarding and recognizing their qualities and contributions in ways that are meaningful to them
5. Getting to know them, show an interest in their wellbeing, help them in feeling fulfilled
6. Providing and encouraging connections with mentors and advisors
7. Asking for and listening to feedback and input about the organization, involving them in decisions, creating a sense of trust to move forward
8. Encouraging physician retreats, team building, training in problem solving and conflict resolution
9. Conducting regular and constructive performance appraisals
10. Offering career development opportunities, to provide ways to develop abilities, learn new skills, acquire new knowledge, realize their potential

The return on investment for engaging and collaborating with physicians is enormous.  Creating trust and alignment between management and physicians will allow healthcare organizations to best achieve their desired outcomes.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at mgautam@rogers.com. Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.