Bill O'Connor, MD, vice president of consulting for Orion Health says he has been working on helping health systems increase physician engagement for more than 20 years and it has been "an uphill battle the whole way."
"Unhappy doctors have unhappy patients, and in places that have low physician engagement, they are unengaged, they're unhappy, and they tend to have patients that are more unhappy than places that have good physician engagement," O'Connor says. "It really does make sense."
Administrators must start to think more about what the working relationship is like for the physician, and nurture that.
"You can't improve patient satisfaction if you have a bunch of miserable physicians taking care of patients," he says. O'Connor recommends engaging physicians upfront and early, including involving them on the selection and implementation of strategies.
"Getting buy-in all the way along gives them a feeling that they are more willing to back something because they see how it ties in to the overall health system or payer strategy," O'Connor says.
Giving physicians feedback is also key. O'Connor says presenting concrete data that a new initiative works can work wonders in getting someone onboard with a new system.
"When you show physicians actual concrete data, they change their minds very quickly," O'Connor says. "No one wants to be the worst physician in the practice.
Mark W. Mullarkey, senior vice president of Texas Children's Hospital, says the health system has worked hard to increase physician engagement, employing many of the strategies O'Connor outlines above. For Children's hospital, the payoff has been huge.
Increasing physician involvement led to improved patient access to care, provider productivity, meaningful use metric outcomes, and physician documentation in inpatient cases. It also reduced the inpatient length of stay.
Mallarkey says the health system's engagement efforts also targeted physician practice, increasing collective physician productivity by 15% to 20%. He says subspecialties were targeted, since previously only about 50% of subspecialties saw patients in 10 to 14 days.
Now, 70% to 78% of subspecialties see patients within that time frame through the use of templates, EHRs and other efficiencies identified by physician leaders.
For Texas Children's, these efforts meant that instead of a projected $50 million to $60 million revenue gap, within two years, the hospital saw a margin swing of $70.2 million through revenue enhancements and cost containment, Mullarkey says.
Through efficient staffing, watching overtime and temporary worker costs, Mullarkey says the revenue trend is expected to continue and is allowing the health system to expand its facilities to accommodate growing patient demand. He says Texas Children's is already adding a new hospital on the north side of Houston, and a 19-floor expansion to its main campus critical care unit and operating rooms.