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CVForward  >  Physician Alignment: "WIIFM"

PHYSICIAN ALIGNMENT:
"WIIFM"–A STEP-BY-STEP GUIDE TO GETTING YOUR PHYSICIANS ON BOARD

 

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:

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“The only people who like change are babies with wet diapers.” “The only people who like change are babies with wet diapers.”

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.

Here is a step-by-step breakdown of a FAILED initiative: Here is a step-by-step breakdown of a FAILED initiative:

1. The initiative is dictated to the physicians 1. The initiative is dictated to the physicians

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.

Physicians become alienated from the initiative Physicians become alienated from the initiative

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.”

Physicians begin spreading bad word of mouth Physicians begin spreading bad word of mouth

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.

Threats begin to surface Threats begin to surface

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.

The initiative slowly dies The initiative slowly dies

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.

Here is a step-by-step guide for a SUCCESSFUL initiative: Here is a step-by-step guide for a SUCCESSFUL initiative:

Reach out individually Reach out individually

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.

Form a steering committee Form a steering committee

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.

Create the framework for the business plan Create the framework for the business plan

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.

Update your physicians regularly Update your physicians regularly

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.

Above all, continually reinforce what's in it for them Above all, continually reinforce what's in it for them

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.


Related Content

Visit these websites for more helpful information from other industry thought leaders.

Co-management of the Cardiovascular Service Line: Using Hospital-Physician Alignment to Achieve Common Goals

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.

Hospital-Physician Collaboration: Landscape of Economic Integration and Impact on Clinical Integration

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.

Are Cath Labs Immune to Hospital Consolidation?

By Brian Contos

Article from Advisory Board

An interesting and somewhat surprising hypothesis.


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