Physician career progress was historically based on credentials, seniority, clinical reputation, and political standing. Certainly, physicians with higher levels of emotional intelligence and communication skills were at an advantage. They might have higher patient satisfaction scores and might be seen as more effective leaders. But these attributes were not universally accepted as a requirement for success.
This is changing. Even the Accreditation Council for Graduate Medical Education (ACGME) has defined a set of core professional competencies that include system-thinking, professionalism, and interpersonal communication skills. Accordingly, organizations are starting to commit resources to training physicians from residency through leadership. As we observe these efforts, though, we see a few important gaps:
- A lack of interactive learning;
- A lack of focus on system-level outcomes; and
- Little meaningful feedback on self-awareness
Even though many would contend that success, particularly leadership success, is mostly about relationships, physician training rarely covers relationship and communication skills – or self-awareness as the foundation for improving both.
It’s also important to note that organizations have not historically used 360s or performance reviews with physicians – which actually reinforces a lack of self-awareness and appreciation of their impact on others.
Our approach is to invest in physicians as individuals, but then engage them in, and hold them accountable to, broader, organizational goals. For the past decade, many organizations have done exactly the opposite.
Physicians are trained to be accountable to their patients, one at a time. They’ve honed those skills – building their expertise and applying it to a patient problem to find the right answer. Then, we started showing them organizational metrics – told them they are accountable for improving department level financial performance or patient satisfaction scores – without providing any training, or seeking their input on how we measure success. Is it any wonder why they are frustrated?
A New Approach
How do we start to fix this problem?
- Think about physicians as a unique, critically important, workforce – a workforce that needs dedicated talent management resources.
- Build individual relationship and communication skills on a foundation of enhanced self-awareness.
- Self-awareness starts with diagnostic tools –
tools that are commonly used for talent management. When working with physicians, though, these tools
- Short and engaging
- Scientifically sound
- Able to present data in a meaningful, easy to contextualize manner – i.e. tools built with physicians in mind that present data as concrete recommendations to address real, relatable challenges.
- Built into a larger, more meaningful initiative so that physicians see the value – the value of developing their own skills, the importance to their own success – success that is in line with the organization’s goals.
Understand the Tools
It’s also important to understand the various types of tools and data you can use and how they differ. (There is often confusion on this topic.)
- Supervisor ratings – if you expect anyone to meet some standard of performance, they need feedback on their effectiveness. Supervisor ratings are rarely done well, but they are a starting point. Define the expectations and train leaders on how to provide useful feedback.
- Self-reported ratings – As part of any performance evaluation, it’s helpful for the individual to rate his or her own ability to “delegate effectively” or “engage staff in a positive manner”, etc. – then we can talk about gaps between their own rating and those of others.
- Peer ratings of performance/behaviors – This is where a 360 degree assessment is valuable. A simple survey that asks peers, colleagues and other staff to rate the physician’s effectiveness – not as a clinician, but as a communicator, or as a leader. Make no mistake about it, some physicians do NOT like this process, but perception is reality. If used correctly, this data can be incredibly valuable.
- Personality assessments – These don’t measure actual performance but, rather, tendency and behavioral “traits.” – If used properly, these tools can provide amazing insight into what is driving performance and behaviors.
When combined, these data points create a powerful map to improving performance and to individual development. Any of these data points can be mis-used or mis-understood. They should be deployed deliberately and as part of a clearly defined project that the physicians understand.
An example: We recently spoke with a Department Chair who decided that he wanted 360 data on every physician in a leadership role. He did this, however, without communicating the goals of the project, or how this data would be used and to what end. As you can imagine, it was NOT well-received by senior physicians who have no experience with this process – ratings of their performance by peers and staff. Good luck going back and convincing these physicians you want to build a program to help them improve their performance and career success. Don’t make this mistake
The expectations have changed. Asking physicians to meet these expectations without a real, substantial talent management function and process to support these efforts is unreasonable and a disservice to physicians – it will only add to their frustration and burnout.