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Physician Engagement Is Built, Not Bought

Physician Engagement Is Built, Not Bought

by Rick Blizzard

First in a series on measuring and improving physician engagement

One of the key challenges facing hospital administrators is strengthening the bond between the hospital and its physicians. Some administrators I've encountered feel the best way to establish that connection is simply by individually approaching members of the medical staff and asking them what they need -- and responding by spending money on new equipment and technology. While this strategy might seem like a good way to make physicians happy, from what I've observed, such technological improvements are somewhat temporary solutions.

Hospitals can't really buy physician engagement -- a notion that may come as a revelation to many budget-conscious administrators. Engagement is not necessarily based on concrete, rational factors; rather, engagement stems from emotional attachment. So how can hospitals increase the level of emotional attachment among their physicians?

Measuring Emotional Attachment

Gallup helps hospitals measure their physicians' emotional attachment by asking physicians to rate their agreement with eight different statements, which are divided into the following four hierarchical levels.

Confidence: The foundation of the emotional attachment pyramid, Confidence items measure whether physicians trust their hospitals and believe they fulfill their promises.

Integrity: The Integrity items measure physicians' feelings about whether their hospitals treat them fairly and make things right when a problem occurs.

Pride: The Pride items determine whether doctors feel good about practicing at their hospitals and how practicing at the hospital reflects on them as doctors.

Passion: These questions tap a truly profound level of attachment: Physicians who are passionate about their hospitals view them as irreplaceable.

Which level provides the greatest opportunity for improvement? To find out, we analyzed the responses of 7,000 physicians in Gallup's physician engagement database, and assessed the areas in which physicians tend to give relatively high scores and relatively low scores.

The graph illustrates the deviation from the mean on each of the emotional attachment items. Items with a positive deviation receive higher-than-average scores from physicians, while items with negative scores receive relatively low scores from physicians.

It might be assumed that it would be easier to get agreement on the lower items in the hierarchy and thus, it is no surprise that physicians give higher scores to the "name I can always trust" item at the bottom of the pyramid than they do to the "I can't imagine a world without" item at the top of the pyramid.

It is encouraging to see that physicians score highly on the Pride items ("I feel proud to be a physician at this hospital" and "This hospital always treats me with respect"), which are in the top half of the hierarchy. Physicians are looking for hospitals that treat them well and reinforce their self-images. (In social situations, for example, physicians want to be proud to tell others about the hospital they work for.)

On the other hand, the Gallup scores indicate that one of the most formidable barriers to physicians' overall emotional attachment to their hospitals is an item at the bottom of the hierarchy: the hospital's ability to deliver on its promises. Hospital executives should beware of promising physicians too much. Physicians may be pleased when the hospital administration commits to always giving them 8 a.m. operating room times. But later, when the hospital is not able to deliver on that promise each and every time, physicians will be more angry than they would have been had such an untenable promise never been made in the first place.

Bottom Line

If hospital administrators promise to improve quality at their facilities, they need to communicate a plan with specific objectives, and regularly update physicians on the hospital's progress toward achieving those goals. And problems that arise along the way should never be ignored -- rather, administrators should show physicians respect by communicating frequently and working toward a satisfactory resolution to the problem.

Next week's article will discuss what differentiates average hospitals from the best hospitals when it comes to physician engagement.

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