Becker's Hospital Review

42 Executive Briefing: Hospital-Physician Relationships Sponsored by: 7 Tips on Avoiding, Resolving Hospital- Physician Conflicts H ospitals and physicians are grappling with major changes to their industry, as both parties strive to improve qual- ity and outcomes and reduce costs while dealing with changing payment structures. This goal of achieving the triple aim will be impossible to attain without achieving alignment and col- laboration between physicians and hospitals, according to Rick Sheff, MD, principal and CMO of The Greeley Company. "We cannot improve quality and reduce costs without changing how we take care of patients. The corollary to that is physicians have to change how they practice medicine, and hospitals have to change how they take care of patients," he says. Ideally, they would do that in partnership with one another. However, there are several other issues at play in healthcare today that can lead to conflicts between the two groups and hinder advancement toward the shared goal. For example, one source of conflict can be the issue of competi- tion. To stave off the effects of the nationwide physician shortage, many hospitals are recruiting physicians at an accelerated pace. However, an organization may recruit a physician in a certain spe- cialty, and physicians already in the market in that specialty can perceive this as a threat to their practice, leading to trouble. The installation of electronic health records at a hospital is often another a sore spot for physicians, who may see the new work- flow as something that slows them down and takes time away from treating patients. "It's important to recognize that when the hospital changes to an electronic medical record, physician pro- ductivity goes down on the order of 20 percent," Dr. Sheff points out, which also affects their livelihood. This can lead to resent- ment among the medical staff, and a possible conflict. One other major source of conflict stems from hospital CEO ten- ure time. Physicians typically stay in one market for an extended period of time, while the average hospital CEO tenure is three to five years. That means physicians see executives come and go while the physicians remain stalwarts in the community. Accord- ing to Dr. Sheff, this causes physicians to think, "Why should I trust you, believe in you or work with you when in three to five years there will be someone else who comes in with their own programs?" This lowers trust between the parties and can lead to disagreements. Preventing conflicts While there are factors at play that can lead to these disagree- ments, hospital leaders can use the following three best practices to foster positive relationships and alignment with area physicians and thus avoid conflict. 1. Communicate, communicate, communicate. "Communica- tion is critical," Dr. Sheff says, but there is one major issue: Com- municating with physicians is anything but simple. Physicians tend to be extremely busy and many no longer call the hospital their home base, making them difficult to reach. Therefore, hospital leaders need to reach out to clinicians through different types of media and use multiple touches. "And, when it's really important, do the communication person-to-person, face-to-face," he says. 2. Be transparent. The perception of hidden agendas under- mines trust, Dr. Sheff explains. Therefore, hospital C-suiters need to be as transparent as possible with their physicians when it comes to anything that will affect their practice. 3. Be impeccable with your word. In other words, hospital ex- ecutives need to mean what they say, say what they mean and follow through. "It takes years to build trust, but it takes seconds to destroy it," Dr. Sheff says. After all, it is difficult to have trust and a positive working relationship after promises have been broken. Resolving conflicts While these best practices can certainly help prevent major hos- pital-physician conflicts, some differences do arise and conflict occurs anyway. "We've had situations where a community group practice and the hospital have had their guns fully loaded, locked and pointed at each other with itchy trigger fingers, ready to go to war," Dr. Sheff says. Answering the call of hospital and medical staff leaders We're not exactly superheroes. But we help hospitals to confront challenges and achieve excellence every day. Just a phone call away, we're ready to partner with your forces to tackle whatever you're facing with efficient, powerful, bullet-proof solutions. Got compliance concerns? Physician-related problems? Credentialing or quality conundrums? Call The Greeley Company. What we do Our work with hospitals nationwide targets both traditional and contemporary challenges in the following four core areas: 1. Medical Staff Optimization & Physician Alignment 2. Compliance, Accreditation & Quality 3. Credentialing & Privileging 4. Environment of Care & Life Safety Typical outcomes • Quality improvement • Cost reduction and improved margins • Accreditation and regulatory compliance • Physician engagement • Process optimization Outsourcing Solutions Interim Staffing External Peer Review Leadership Seminars & Onsite Education Consulting 75 Sylvan St., Suite A-101 Danvers, MA 01923 888-749-3054 info@greeley.com www.greeley.com ©2014 The Greeley Company The Greeley Membership Program "In every human relationship, there are moments when someone says or does something that has an impact that was not their intent. In every medical community I've ever been in, they have a history of moments of impact and intent, and every one has left scar." — Dr. Rick Sheff, CMO of The Greeley Company

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