In other industries, individuals with similar levels of training and responsibility, individuals in whom so much is invested and of whom so much is expected, have a solid support structure and a plan for success. This is, frequently, far from the case with physicians. Their success or failure is often left to chance.
The medical school and residency experience have not changed much in the past thirty years. Thirty years ago, though, the care delivery system, and the business of medicine, were much simpler. Leaving residency, the physician’s training would serve her well and she had time to figure out the non- clinical issues that would surround and influence her practice.
Leaving Success to Chance?
This is no longer the case. Physicians have to quickly learn to be effective in a highly complex, rapidly evolving, environment. They enter the early phase of their professional career without tools or a plan to chart a course for a success. Maybe they join a well-run, supportive group. Maybe they find a talented mentor. Maybe they are blessed with a high level of adaptability, resilience and emotional intelligence. Maybe they quickly learn to navigate all that comes with practicing medicine in a complex organization. Maybe they happen to have real-life skills to manage their life outside of their practice…… or maybe not.
With all of this in mind, someone asked me recently – “What does a physician need to be successful?”
How do we define success? Let’s ignore for a moment, all that goes into being an effective clinician. Let’s think about “success” in terms of finding a level of professional satisfaction, and a rewarding career.
This list is, by no means, comprehensive, but it’s a good start:
The Right “Fit”
The number one reason that physicians leave a practice is a real or perceived lack of “fit” – a mis-alignment of goals and expectations. Physicians right out of residency, particularly, have no way to evaluate a prospective work situation. Their view of practice is shaped by their residency experience – they have no other frame of reference. They don’t understand what clinical support they’ll need, no idea about reasonable performance goals or how to achieve them and generally, don’t understand their employer’s expectations. They need a basic understanding of what success looks like and whether the situation being presented to them is aligned with their goals and expectations. Potential candidates need to deliberately evaluate a work situation – interview key individuals and ask specific questions – about operational issues and about the culture.
Navigate Organizational Dynamics
Physicians can usually handle patient care responsibilities. What frustrates them is trying to understand and navigate the organizational dynamics and relationships that impact their effectiveness. Physicians don’t get into medical school or succeed in residency because they are experts in this area. Some enter practice with only a vague notion of how a complex health system is structured and how things get done. Physicians need to understand organizational dynamics and learn to be effective and to achieve their goals, within that framework – or how to effectively influence change. Contrary to some of what they learn in their training, top-notch clinical skills are not enough.
Understand Service Line Operations
Particularly for certain specialty areas, an effective service line strategy is imperative for physician success. The physician should understand the basics of the service that occurs around them – from primary care, to referral patterns, the competitive landscape, etc – so they can work with hospital administration to move toward a work situation that aligns with their goals. Of course, the hospital needs to commit resources to the effort, too.
Understand the Business
Physicians may not want to hear this, but you can’t be effective or meet the needs of patients if you don’t understand the business: How the practice is paid; How various quality programs work; How to efficiently and effectively use staff: To manage documentation requirements; To get insurance authorizations, and make the best use of your clinic time. Moreover, you can’t be a productive team member, looking for ways to improve productivity, the patient experience, or reduce costs, if you don’t understand how it all works around you. Those who are unwilling, or unable, to master these concepts end up spending too much time on them and are prone to burn-out.
Personal Financial and Legal guidance
This should seem obvious – but find good professionals to help you – ideally, professionals who work with physicians and understand the complexities of healthcare. Whether it’s that first employment contract, the first time you are named in a med-mal suit, licensure issues, or how to ensure your long-term financial security – you need expert guidance. I’ve seen too many physician clients facing preventable financial challenges, licensure issues, or Medicare fraud claims, simply because they failed to obtain competent guidance.
People need to actively seek and lean on effective mentors. Be aware, though, that not all successful individuals are effective coaches or mentors. Mentoring is a skill. We’ve found that physician-specific personality inventories can create a mentor guide to better understand the physician’s natural tendencies and tailor the mentoring approach.
Behavioral and Leadership Skills
There is a growing recognition that physicians need to actively understand their own personality and behavioral tendencies, and take deliberate steps to improve performance.
For instance, the team at J3P has been doing workshops for residency programs and various specialty associations on enhancing self-awareness as the first step to improving communications, emotional intelligence, and leadership skills. This should start during medical school and continue throughout your career. It is imperative for physicians to understand the difference between their identity (who they think they are) and their reputation (how they are seen by others) and how this may influence their career.
A Pro-Active Strategy to Avoid Burnout
The nature of the work, itself, coupled with rapidly increasing and changing stressors –have led to an alarming rate of burnout. While intervention is fine, prevention is better. We’ve started to work with medical students and residents, consistent with new ACGME requirements, to prepare physicians to think about their own wellness. Health systems are starting to provide tools, but they are often perceived by physicians as nothing more than “encouraging the physician to better handle an unmanageable workload.”
To avoid this perception, programming targeting burnout should focus on a holistic approach creating a culture of wellness. This includes operational improvements to lessen the workload and frustrations that contribute to the stress. engagement, burnout, turnover, and physician career satisfaction, are all related to the broader concept of “physician success.”
Take Ownership Over Your Success
Rather than isolated programs to address each of these problems, organizations need to think about physicians as valuable resources and build strategies, platforms and tools that position physicians for long-term success.
As few organizations actually do this, we encourage physicians, at all phases of their career, to take ownership over their own success. It’s your business, our practice, your success. Your expertise and talent are part of that success. Don’t forget the other variables that sometimes play an even bigger role in your career success and satisfaction.