A decade ago, few health systems had robust talent management functions. This has changed. Healthcare learned from other industries that these functions are critical to individual, and organizational, success.
What about Physicians?
What about, perhaps, our most important workforce – physicians? In decades past, we didn’t think about a physician “workforce.” Physicians were unique professionals, mostly independent and the hospital’s interactions were through the medical staff structure. Physician “success” was an issue for the physician or his or her practice. Now, though, most systems have large networks of employed physicians. Where are the talent management resources for this critical group? I’ve heard a few reasons why we don’t think of physicians this way:
Physicians are Unique.
Wrong. Physicians are unique but they are professionals, doing a job, – a unique and important job but a job, nonetheless. It’s their career and they need resources and guidance to be successful – just like any other professional. This is, particularly, true as the profession undergoes rapid changes. The development of large employed networks of physicians happened so rapidly that the talent management infrastructure was not even an afterthought.
Many systems have developed physician leadership programs but these offer nothing to early-career physicians, though. Just like with other roles, there is plenty of evidence that training and development efforts improve performance. Yet, all of our energy goes into recruiting and a short on-boarding process.
All That Matters are Clinical and Technical Skills.
Wrong. A physician’s ability to diagnose and treat illness, or to prevent it, are the core competencies and still the most important measure of performance. Physicians though, don’t generally struggle because of a lack of clinical or technical abilities. They do, often, struggle because of poor business acumen, emotional intelligence, communication skills, or a lack of sound career guidance, and a structured opportunity to grow and develop.
These Resources Would be Too Expensive.
Wrong. Physicians are primary revenue drivers, and a huge cost center – and they are NOT interchangeable commodities. Why would we not invest in improving physician performance and ensuring long, successful, productive careers? If a spine surgeon is able to perform ONE more surgical case a year, because she is energized and engaged and the OR functions as it should – that might be $40,000 in additional revenue for her hospital. Have you calculated the cost of physician turnover? You can’t afford to invest in physician success?
Where’s the Organization’s Accountability?
Physicians are struggling. Turnover is increasing. Career satisfaction is declining, and burnout is on the rise. Is there another industry that so neglects its most important human asset? We spend time and money to train and recruit physicians – only to get them credentialed and then hope they succeed. If they express frustration, they are labeled as disruptive or burned-out.
There is a growing conflict between the organization’s expectations (compliance, productivity, efficiency, teamwork and collaboration, adapting to daily change, ensuring a positive patient experience, and leadership) and the expectations of the individual (the opportunity for rewarding work and a sustainable, satisfying career, and reasonable work-life balance). Rather than recognizing this conflict and pro-actively working to make physicians successful, we wait until they fail and refer them to wellness or disruptive physician programs, or they simply leave the organization.
A Plan for Success
Every physician should start a new position with clear expectations and a plan for success. With a growing provider shortage, why do we leave this to chance? Why not establish clear performance expectations, understand what it will take to meet them, how they align with the individual’s goals, strengths and challenges, and build a plan around this data. The agreed-upon plan would operational needs, career goals, and identify resources, programs and mentors.
Too often, the hospital is fixated on finding a physician to fill an open position. They don’t really work to understand whether it will be a good fit. The physician often doesn’t’ even know WHAT questions to ask. After two years the physician realizes this isn’t what she’d hoped for. She has frustrations and sees no plan or support to overcome those frustrations. She has no plan for success. She moves on and you start over. Or you hire her without understanding her behavioral strengths and challenges – and put her in a situation where she is sure to struggle.
Physicians are overburdened with non-patient care tasks. It’s frustrating. Yes, the demands have changed and some of this is unavoidable. Unfortunately, as organizations change care delivery models and administrative process, they rarely think about physician productivity and priorities. When I was a practicing attorney, I had a team around me to handle any task that took me away solving client problems and billing hours. It made sense to invest in these resources because it allowed me to do the work I was hired to do. How much would it cost to fix the problems that keep a surgeon from doing that one extra case a year?
How much easier it would be to recruit a physician if she knew that on day one, there was be a plan for her long-term success – that the organization was committed to her performance, her goals, and her career? I once suggested to a COO that he commit an additional resource to a rather large Orthopaedic service line – a resource focused on understanding and improving physician needs and supporting their growth and performance. His said he couldn’t afford the investment. He clearly didn’t understand service line productivity and margin, or the cost of physician turnover. I suggested that he couldn’t afford NOT to make that investment. (He did, agree, however, to improving the hiring process – it was a start.)
The Case for Physician Talent Management:
- Physician performance metrics – quality, productivity and efficiency data, are readily available.
- We know that behavioral skills impact individual success and organizational performance. Collaboration, leadership, communication skills, planning and organizing, etc. impact patient experience scores, staff and physician engagement, turnover, the ability to innovate, your culture, and patient outcomes,
- Physician wellness and career success and satisfaction are already being measured – make that data useful and actionable.
- We can help to move these metrics through focused operational and organizational development efforts – at both the individual and group level.
- High performing organizations invest in talent management for other roles, because it works.
- The concept is not unique. The approach is a proven one. We just need to implement solutions that meet the unique needs and context of physician performance. Physicians are already overburdened so we need to be efficient and effective and find solutions that work for physicians.
There’s no logical reason for leaving physician success to chance. The investment will have a positive impact on patients, on the organization and on the success and well-being of physicians, themselves.