Issue link: https://beckershealthcare.uberflip.com/i/568709
79 THOUGHT LEADERSHIP challenges facing health systems today. Although it may feel as if physicians and administrators are navigating through separate waters, the "why" of what both are doing is usually driven by the same motive: to help the patients we serve. And the only way we will reach our desti- nation is by working together to get there. Our responsibili- ty as leaders requires that we enhance our working rela- tionships to create high-performing teams of profes- sionals focused on improving the safety, quality and expe- rience of care for patients, while also ensuring the opera- tional and financial health of our orga- nizations. We must leverage our shared passion to serve peo- ple by developing relationships built on trust and mutual respect and by work- ing to understand the skills and values physicians and administrators bring to table. An adaption of an effective project management tool — the responsibility matrix — can be invaluable in this regard. In project management, the responsibility matrix is a tool used to define the powers of individual team members for various parts of projects. It provides an organiza- tional prompt for all stakeholders to understand the responsibilities and accountabilities of each per- son. When adapted for healthcare delivery considerations, it can provide transparent insight into the overall relationship between administrators and physicians, and it can help both better understand the different personalities, perspec- tives, and skill sets that each brings to hospital operations. Created honestly, it can identify our per- sonality blind spots, and allocate responsibility based on our indi- Physicians Administrators Acknowl- edge change The changes sweeping healthcare are redefining the way we deliver care for patients. The impact touches everyone — payers, hospitals, individual physicians and patients. Recognize that a paradigm shift has occurred, and that value-based care, transparency and greater account- ability are here to stay. The faster we recognize and accept the new normal, advance on the "grief curve" from denial and anger to acceptance, the easier it will be to work through these challeng- es and advance our work of delivering optimal care for patients. Just accepting that things are different, however, is not enough. To be effective partners, we have to follow the new issues and under- stand their impact on healthcare and our practices, and we have to understand ways to adapt. Validate suffering Change is hard for everyone. Physicians are no exception. The dramatic changes in the healthcare environment are significant- ly disrupting physicians' routines. State- ments like, "I went into medicine to help people, not to be a bookkeeper," are com- mon. Physicians feel alone and victimized, and they are increasingly viewing medicine as them against the world. Physicians' training ingrained the need for rugged individualization and to be a strong advo- cate for patients. A little empathy in this regard can go a long way. Validate your physician colleagues' feelings by recogniz- ing the impact of these changes on their career and letting them know that you will navigate the new environment with them as partners. Own safety and quality Every physician has personally witnessed the variability of care delivery and its im- pact on outcomes. Many of the changes influencing medicine today reflect our failure to take control of safety and qual- ity. It should bother us that other coun- tries have standardized the treatment of some diseases whereas the U.S. has not. If we recognize this variability exists, why do we continue to allow it? We must own these issues. Physicians control creden- tialing and privileging through medical governance, and quality processes through reporting and review. Using these tools, we must embrace transpar- ency of data, standardization of practice and more robust exchange of informa- tion to improve care delivery. Communi- cate Keep physicians informed. Administrators often tell me they're doing everything they can to communicate with physicians, yet physicians often tell me they feel as if they're in the dark. There are nuances to communicating effectively. For physicians, it is not enough to merely communicate a decision. They need to know the "why" behind it as well. They are deeply analytical and want details, so provide them. Commit to transparency and ensure inclusiveness. Consistency is also important. Banging the drum of cost reduction when the hospital is having record years of financial perfor- mance does little to build confidence that the information you are sharing is accurate. Lastly, effective communication is a two- way street. In addition to sharing informa- tion with physicians, are you listening to what they have to say? Promote accountabil- ity and peer monitoring We must hold each other accountable and monitor our peers. Many physicians will say, "We already do." That's not quite true. I marvel at our willingness to allow some physicians to continue to deliver care to patients when we know they should not. Operating room personnel, for example, are aware of surgeons who have "passed their prime" and would never allow them to treat their family members. We turn a blind eye to these realities and occasionally allow some colleagues to practice outside the stan- dard of care. Help physicians under- stand the business I hear administrators make comments about physicians and their lack of under- standing in the "business" of medicine. The business side of medicine is complex. Rather than fall back on, "They don't under- stand why this matters," we need to help educate our physician partners so they bet- ter understand the reason behind some of the things we do. Recently, I heard a COO ask, "Don't they understand that if we just do what they want, we will all go to jail?" In fact, the physicians didn't understand, but they would with the proper insight into the business.