CVForward > Physician Alignment: "WIIFM"
When cardiovascular service line (CVSL) leaders are attempting to create initiatives that will change how their CV practice runs, it is all too common to run into resistance from physicians. Kevin "Casey" Nolan, Managing Director of Navigant Consulting, has a simple explanation:
There is no doubt about it—physicians can make or break your initiative. Whether they are employed by a hospital/system or an independent private practice, physician alignment is essential. According to Nolan, the key to getting them on board is, "It's everyone's favorite radio station: WIIFM. What's In It For Me."
Communicating what's in it for them is a must if you want to achieve alignment.
If you want to ensure failure, tell physicians "It's the right thing to do" or "It's the best thing for the hospital" and expect them to accept that.
By dictating the initiative to them, your physicians will view it as, “Administration is making the decision and I have to do more work, give more effort, and give up more money.”
If physicians are not on board, they are letting their colleagues know it. They are telling other physicians, nurses, and extended staff all the reasons they feel the initiative is not a good idea.
After a certain amount of passive physician resistance, a more “active” resistance begins to occur. Many CVSL leaders have seen physicians threaten to leave (and take their patients with them) because of initiatives they do not support. Physicians have also been known to go around administration and express dissatisfaction to a contact on the hospital board.
After enough physician resistance, the initiative often gets deprioritized or funding is reduced.
CVSL leaders know this story all too well. With physicians working against you, the success of your initiative is in jeopardy. However, when your initiative has physicians who are actively engaged and pulling for your initiative, it is a different experience altogether.
“If you dictate to physicians, you’ll fail,” says Nolan. “You want to seek their input so they have ownership. Plus, they’ll have great ideas that will make the initiative more successful.”
You want to be sure to point out what’s in it for the physician. Make it clear how they will benefit. Will they get access to new equipment? Greater capabilities of square footage? Will they get additional staff? Will they make more money? Reinforce those things when you speak to physicians about the initiative.
Reach out to key physicians, present the basic idea you are considering, and get their thoughts. Ask if they have any experience in the area. Listen to what observations they have on the subject.
Get a small working group of physicians together to discuss the initiative. Show them the data. Gain their opinions on the opportunity, the required investment, and how they think it compares to competitive offerings. Find out what questions they have and what data they’d like to see moving forward.
Present your physician team with the outline of a business plan for the initiative. Get their buy-in on timing, implementation, and stakeholder responsibility. Get their feedback and build it into the business plan—with physicians as co-champions.
Once the initiative is underway, do regular check-ins with your physicians. Ask them how it’s going. Find out what’s not working and where alterations need to be made. Keep them engaged and use them as part of the ongoing solution.
Whether you're developing a clinical comanagement agreement, establishing satellite cath labs, or standardizing on a single vendor—be sure that all your physicians are tuning into that most important "radio station": WIIFM.
Visit these websites for more helpful information from other industry thought leaders.
By Bruce Payton and Kristin Truesdell
Journal article from Cath Lab Digest
This article discusses the use of a comanagement system as a strategy to achieve physician alignment.
By Lawton Robert Burns and Ralph W. Muller
Journal article from The Milbank Quarterly
This article analyzes the hospital-physician partnerships that focus on the economic integration of hospitals and physicians and the goals they are designed to achieve.
By Brian Contos
Article from Advisory Board
An interesting and somewhat surprising hypothesis.
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