10 Signs of Troubled Physician Alignment

Studer Group, a Gulf Breeze, Fla.-based consulting firm, is holding its "Take You and Your Organization to the Next Level" meeting in Chicago this week. At the meeting Tuesday, Quint Studer, founder of the company, spoke about 10 of the top challenges in healthy physician-hospital alignment and the importance of consistent leadership and physician feedback systems.

Here are what Mr. Studer identified as 10 signs of a hospital-physician relationship in need of repair and improvement.  

1. There is a lack of confidence and trust between physicians and hospital leaders. Mr. Studer said the number one problem in poor hospital-physician alignment is physicians' lack of trust in administration. The reason? Most physicians feel their administrative team does not stick to operational projects, team initiatives or cultural improvements.  

2. Too many changes are made without physician input. When hospital leaders do not solicit, recognize or incorporate physicians' input or feedback into new strategies, there is little to zero physician buy-in for those operational projects, team initiatives or cultural improvements.  

3. There are no physician champions. If physicians are not designated to lead initiatives, this can result in apathy and unsteady physician engagement.

4. Physicians do not receive meaningful feedback. Only one in three physicians receives feedback data on performance, according to the Studer Group, and only one in four receives patient experience data. The lack of meaningful feedback exacerbates or causes most every other problem on this list.   

5. Leaders do not create shared levels of accountability across the entire organization. For instance, if a physician has many of his/her patients in a certain unit of the hospital, does that physician have influence on how that unit's manager is being evaluated? Physicians should be able to weigh in on evaluation metrics and goals to reinforce shared accountability.

6. Leaders do not provide evidence-based best practices for physicians. "We can't just say, 'Here's why we're doing this,'" said Mr. Studer. Instead, leaders should link specific behaviors to specific clinical, quality or operational outcomes. Physicians are driven by evidence.

7. There is a lack of reward and recognition in the hospital. Physicians like the word "recognition," said Mr. Studer, but hospital leaders too often go to physicians with problems rather than solutions. He encouraged leaders to seek out physicians and share messages of encouragement and compliments.  

8. Leaders and physicians are neither implementing nor adhering to agreed-upon standards of behavior. Hospital leaders may not always implement what they promised. "When we say we're going to hold someone accountable, we have to do it," said Mr. Studer. Unless hospital leaders hold other executive team members and employees accountable to standards, physicians will not buy in. Once you hold employees accountable, physicians often follow suit.

9. Leaders are not managing disruptive physician behavior. "We somehow think we can hire a CMO to solve all these issues. They don't," said Mr. Studer. Leaders should reward and recognize the large majority of cooperative physicians and have a strategy to address those who are disruptive. All managers should receive training on disruptive behavior from physicians and non-physicians. "What you permit, you promote," said Dr. Studer.

10. There is a lack of an aligned vision across the entire organization. A disjointed vision largely results from the lack of feedback systems for physicians. Physicians, nurse practitioners and advanced practitioners should receive meaningful feedback on performance, clinical outcomes and patient satisfaction so they feel connected to a hospital's vision and goals.

More Articles on Hospital-Physician Relationships:

2 Physician Alignment Strategies and How Hospitals Can Adopt Them
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Keys to Success as an ACO: Model Physician Relations Maintaining Entrepreneurial Incentive and Self-Direction

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