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Strengthening the Physician-Hospital Relationship: 10 Keys to Success

Jesse O. Weatherly, III, FACHE, and Stephen C. Nyquist, for HealthLeaders Media, October 24, 2008

An effective relationship with physicians is critical to the success of any hospital, and an effective relationship with hospitals is important to most physicians. But the vexing reality is that the physician-hospital relationship is as complex as it gets. Few professional relationships have such unique and particular dynamics with so much at stake. The relationship between a Major League Baseball player and the front office may come close, but even that simile falls short of capturing the gravity of this blend of personality, responsibility, talent, and pressure. The importance of this relationship coupled with its relational complexities present a constant challenge to the best of hospitals and physicians. Here are 10 ways to strengthen the physician-hospital relationship.

1.The Hospital is the Pace-Setter.
Hospitals need physicians more than physicians need hospitals. Organizational hubris may, for some, make that difficult to swallow—but it's the truth. Simultaneously, hospital leaders must be willing to assume responsibility for the overall liaison with staff physicians. Every medical staff will be characterized to some degree by challenging physicians, specialty turf wars, and entrepreneurial physicians seeking income opportunities that compete with the hospital. Hospital leaders should set a positive pace and tone for the relationship with their physicians by accepting overall responsibility, and they should be prepared to defuse the inevitable conflicts.

2. The Physician as Honored Guest. Successful hospital leaders accept the imbalance in the "professional importance spectrum" and work diligently to overcome the connectional challenges that exist. Most importantly, they communicate in attitude, word, and deed that physicians are honored guests in their organization. Viewing physicians as honored guests will permeate a hospital, from the dietary department to the laboratory to the C Suite, with a positive and appropriate message.

3. Master Relational Dynamics. When hospital leadership views its physicians as honored guests, the groundwork is laid for effective management of the relational dynamics with physicians. Executives and physicians aren't required to be the best of friends, but mutual trust and professional courtesy is indispensable. Hallmarks of relational excellence are listening to and hearing the needs of physicians, showing appreciation for their work and expertise, following through on commitments made, creating a more efficient workplace for physicians, and being transparent with hospital plans, challenges, and financial status.

There is finesse to any communication, but especially so for healthcare executives attempting to communicate effectively with a group as dynamic and intelligent as physicians. Communication needs to be intentional, thorough, and continuous. Hospital leaders should perfect the art of articulating negative facts and difficult events. All leaders are fairly adept at communicating things which are inherently positive; it is the willingness to address negative or delicate matters expeditiously and effectively which separates good leaders from great ones.

4. Ramp up Responsiveness. Hospitals face daily operational challenges, and as a result there is always a "fire to extinguish." Further, the typical board of trustees and medical staff structure dictates numerous meetings, which can become ends unto themselves. This creates a rigorous and hectic work schedule for most hospital leaders. An unintended consequence, however, is that leadership may be convinced they are being responsive, when in fact the majority of physicians perceives the exact opposite. Hospital leaders should perform a review of recent important decisions, and then develop a new performance metric and process for decision making. Physicians will notice and appreciate the difference.

5. Run a Great Hospital. Although this sounds old-fashioned, it's still true. A well-run hospital will not be ignored by local physicians and is the underpinning for a successful relationship. Physicians respect excellence. They have to trust that their patients are being referred to a safe, high-quality hospital. Physicians will be more accepting of medical staff and board committee appointments in a hospital characterized by excellence, and contribute further to the clinical and operational strength of the organization.

Physicians are also attracted to hospitals that succeed financially—confirming for them effective leadership, wise strategic planning, and an organization that is able to keep up with technological advances. At the end of the day, beyond the noise of the daily friction of the physician-hospital dynamic, a well-run hospital will do more to generate physician alliances and loyalty than any other strategy.

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