I was recently asked if I would be willing to present to a group of CEO’s about physician engagement. I said, “Sure.” It will be a privilege speaking to a group of really smart people who apparently want to know, “What is the secret sauce?”
As I mentioned in my last post, ‘Physician Engagement is Good, But Physician Leadership is Better,’ our ultimate goal should be leadership, not just engagement. To go from distrust and disengagement to physician leadership is a journey. If you don’t have engagement, then it’s not helpful to talk about leadership. First, you need engagement, then leadership.
I’m imagining that the CEO’s would like some suggestions that they can translate into action. My experience informs me that they are oriented towards results, the faster the better. I will have to provide a clear and succinct message. I can do that. Here is the secret sauce: Physician engagement is about Farming, Fishing and Parenting.
Farming: The soil of physician engagement is trust. Without it, there is no engagement. You can cultivate the soil for growing engagement by establishing and building healthy relationships with people. Note that I said, “People” not “Physicians.” This is intentional. We tend to see the species of human beings labeled, “Physicians,” as if they were a special biological taxonomic class. They aren’t. Like all mere mortals, healthy relationships with physicians take time, effort, intentionality, vulnerability, sincerity, truthfulness, selflessness, humility, and forgiveness. If these are present, carefully and respectfully applied, the relationship grows, trust follows, and then you have opportunity. Like any good farmer, a skilled leader knows that healthy soil is more precious than gold. Tread lightly, thoughtfully, and protect it from harm. One more piece of advice. Some soil has been polluted by a Chernobyl. You can’t grow healthy things there. Don’t waste your time.
Fishing: Once you’ve cultivated the soil, built some trust, next you go fishing – or should I say “physhing?” You throw out your line, you give your best effort to present your bait, and you are hopeful that you will catch something.
The fishing analogy has a weak spot and I need to address it quickly. There’s an element of deception in fishing. You present a fake inducement, and you compel the critter to bite. At just the right moment, you set the hook so that they can’t escape. That is not what I’m getting at with this analogy. Trust-based relationships don’t tolerate deception. Besides, physicians are wilier than a cunning cutthroat trout. You will rarely fake them out. If you do, it will only happen once. Then, like Monopoly, you get a free ticket to ‘Go’ and you start all over, with polluted soil. Not good.
Here’s how you fish. Present the physicians with data, good data. That’s your lure. It has to be reasonably accurate data, generally reflective of actual clinical care. It doesn’t need to be perfect, just ‘good enough.’
You also need to understand what the data actually means. Let me be clear here, what it actually means through the eyes of the clinician, not through the eyes of the administrative team. Administrators tend to see data in black and white, or better stated green and red. They take it at face value. Clinicians see data in shades of grey. They take it as an interesting staring point, but by no means conclusive, and at the start, usually wrong. If you’re not a clinician, get some help here. Put the physicians in charge of deciphering it for you. Be vulnerable. Say, “I need your help.” If you find a couple of docs who trust you, and they happen to be trusted by their peers, and they are enticed by the data, and they are willing to help you understand what it means, and they help you address the oddities in the data, congratulations! You have engaged your physicians.
Parenting: Cultivating trust-based relationships, casting reasonably good data into the physician pond, being fortunate to have a couple of physicians engage with you in and around the data, will get you going in the right direction. You then need to give it some time. Be careful to continue working on expanding your trust-based relationships, build your data architecture and capacity, and you will expand the number of physicians you have engaged in deciphering and responding to the data.
This takes us to the point I attempted to make on my last post. You are not done. If there is a desire to elevate the performance of your organization into the highest tier, you need to release these physicians into leadership. The best performing organizations will reach and then go beyond a key tipping point: the hospital no longer asks their physicians to join them in their quality agenda, instead, the hospital asks the physicians, “What is your quality agenda and how can we help you achieve it?” When you have traversed beyond this pivotal organizational moment, you will have cultivated the soil, you will have gone fishing for engaged physicians, and you will have, like good parents, raised and prepared your physicians to lead your organization. Now, release them to lead.
I have simplified this journey for the sake of brevity, and I tried to make light of serious issues. This transformation is much more complex and fraught with obstacles. Nonetheless, physician engagement is fundamentally about building trust-based relationships (farming), about making data-driven decisions (fishing), and about developing people to lead (parenting). That is the secret sauce.