While the proverb “Physician, heal thyself” is meant as a warning against being judgmental, it can actually be a helpful reminder for hospital staff. Remember that physicians must be healthy in order to do their jobs providing care for hospital patients. Physician health in this case is not strictly physical, but also emotional, specifically, physician satisfaction.
To a large extent, a hospital’s brand is built on the reputation of its physicians. Attracting and retaining good professional staff is critical to the facility’s performance, its reputation, and its long-term success. At the heart of this process is physician satisfaction, something that doesn’t happen magically, but requires an organized and sustained process.
In fact, physician dis-satisfaction is a significant problem. A 2014 Mayo clinic study reported that over half of United States physicians are suffering professional burnout, which they describe as “a combination of emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment.” When physicians are in this burnout state, they are more likely to demonstrate poor bedside manner, function below their highest capabilities, and make mistakes. This can result in lower patient satisfaction, poorer treatment outcomes, and higher potential for malpractice lawsuits.
Physician satisfaction, on the other hand, is almost infectious…in a good way. When the doctor is happy, other staff members feed on those good feelings. A more satisfied physician is more engaged and is likely to communicate better with a patient, which leads to greater patient compliance with care directives, greater treatment continuity, and better overall patient outcomes. In other words, physician satisfaction can improve overall hospital performance.
How do we achieve physician satisfaction?
If physician satisfaction is a good thing, how do we achieve it? As in other improvement efforts, a good place to start is by forming a team to assess the current situation, plan a strategy for improvements, and execute. It’s important to have physicians involved in this team as they are very unlikely to accept something that is done to them while they will be more receptive to something that is developed participatively. Given the high level of burnout and dissatisfaction in the field, some number of physicians will be anxious to contribute to an improvement effort that will alleviate their struggles.
First the team needs to understand factors leading to satisfaction.
What will satisfy physicians?
In general, two key methods are very useful in determining what motivates and satisfies people: ask them and observe them.
For physician satisfaction, start with a survey that addresses multiple aspects of the physicians’ worklife, from environmental conditions to personal interactions to compensation and benefits. Include such items as:
- Facility mission and goals
- Facility leadership
- Cross-facility communications
- Level of autonomy
- Other staff relationships
- Patient interaction
- Quantity and pace of work
- Hours of work
- Access to resources needed
- Administrative requirements (paperwork)
- Preauthorization requirements
- Level of compensation
- Overall quality of care
When you administer the survey, be careful not to raise expectations that everything included on the list will or can be changed immediately or even in the long term. Data collected will be used to formulate an improvement plan that may go through multiple iterations.
Observations can also be revealing
A RAND study for the AMA found that “when physicians perceived themselves as providing high-quality care, they were more satisfied.” Physicians spend many years of study (and often accumulate significant debt) so they can deliver patient care and provide healing. If you observe physicians in their daily work, you will see when they are able to act in alignment with their high-quality care goals and when they are frustrated in these efforts.
Understand which activities physicians spend time doing in their roles as care providers and seem to enjoy. Conversely, observe what physicians seem not to enjoy and avoid doing. Then work to increase the opportunities for them to engage in the satisfying parts of their jobs.
For example, you might follow one physician for a day and hear over and over that he doesn’t have enough time in patient interactions and spends too much time doing “paperwork.” A physician’s assistant could be of immense help in freeing the physician for more healing and less recordkeeping. Enhanced electronic health records systems that are user friendly and efficient could also help.
You might observe another physicians who offers innovative ideas for patient care but is repeatedly frustrated when insurance limitations or status quo thinking keeps her from pursuing new approaches. Facility leadership could help to channel support. A process for expeditiously reviewing and approving ideas could also be put in place.
Moving from data collection to action
The examples above are simply examples. When your physician satisfaction team puts together the survey data and observations from your own facility, they are likely to find your own systemic issues that can be addressed. Articulate the top two or three issues and do some root cause analysis to understand why the problem exists.
Working with members of the hospital’s leadership, the team will create an improvement plan and communicate across the organization as they move into implementation. Because physician satisfaction is so important to a healthcare facility, it’s likely this process will be ongoing to sustain gains and address new issues. You will always want to keep physicians satisfied so you can keep them on your team and keep them providing the quality of care that is the core of your facility’s existence.
The EON team has put together a list of survey questions that you can tailor for your organization to conduct a physician satisfaction assessment. Get in touch with us to get started.