Provider engagement is fundamental for the success of a health system. Engagement involves a strategy that leads to a stable relationship between physicians and health systems.
There must be a top-down commitment to engagement. Leadership must establish the culture and create an action plan that results in engagement. Providers must adapt to new concepts, including value-based care models, and be meaningfully included in the process, beginning with discussions and through to implementation.
“An organization can benefit from a plan to engage its physicians proactively,” says Clint MacKinney, MD, MS, associate clinical professor at the University of Iowa College of Public Health. “Physicians will determine the success.”
In the physician-patient relationship, engagement provides an opportunity to implement clinically appropriate and efficient processes to improve care.
“We want to be engaged,” says Ralph J. Nobo Jr, MD, a Physicians Foundation board member. “It’s very frustrating when we can’t be fully engaged.”
While MacKinney acknowledges that while it is difficult work, provider engagement is attainable. Here are some strategies that health systems can use to successfully engage their physicians.
1. Communication and collaboration
When physicians are engaged, they understand how best to take care of their patients, Nobo says. In turn, patients are more likely to follow their care instructions.
“If patients feel their doctor is engaged in their care, they’re more willing to participate in that care,” he says. “I strongly believe that when patients feel their physician is engaged, they know their doctor is trying to help them.”
Traditionally, primary care physicians may only know what’s happening with their patients during an appointment, says Robin Tam, senior vice president of strategy & business development for ConcertoHealth, a medical group that partners with health plan networks to improve outcomes. Outside of the face-to-face interaction, physicians have little way of knowing the medical status of their patients.
ConcertoHealth attempts to bridge that disconnect by providing services through its health plan partnerships to keep physicians apprised of any developments regarding their patients in the such areas as admission and discharge activities, medications, and gaps in care.
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Physicians are delivered insights about their patients they might not otherwise know. “This is the most successful way to engage the physician,” Tam stresses.
Using its strategies of engagement, ConcertoHealth managed to reduce hospital readmission rates by 50% in its Washington market and by 16% in its Michigan market from 2016 to 2018. In addition, hospital admits per thousand were reduced by 16% in Michigan between 2017 and 2018 and emergency department visits per thousand were reduced by 17% in Michigan between 2016 and 2018.
Physicians will engage, Tam believes, if they see a commitment to helping them care for their patients.
“By offering physicians support in the time when the patient is not directly clinically engaged with them, the interaction will become more effective,” she stresses. “Patients will adhere to their treatment plans over time and get the care they need. This makes life easier for the physician.”
2. Lessening burdens and obstacles
Nonmedical responsibilities have always been a part of a physician practice. But outside mandates—from government, hospitals, health systems, and payers and other forces completely out of their control—add to the burden of physicians.
For Nobo, it’s not convincing physicians of the importance of engagement—they already know the importance. It’s convincing outside influencers about the importance. Physicians are supposed to be the leaders in choosing the care model for their patients. Sometimes, though, physicians feel those decisions are taken out of their hands by outside forces, even if they believe it’s not in the best interest of the patient, Nobo says.
“At that point, physicians become disengaged,” he points out.
To have proper physician engagement, it’s important to have the proper dialogue with outside influencers, including hospitals, health systems and payers.
“It is not up to us; it is up to hospitals and third-party payers to allow us to be engaged,” Nobo stresses. “I should be able to speak freely, and I should be able to dictate what is the best course for the patient.”
As for their practices, a health system can provide care management services that benefit physicians and their patients by tending to some of the nonmedical needs such as making sure patients can afford their medications or can get a ride to their appointments.