The Secret to a Happy Marriage

When I married last year, I received a lot of advice: A marriage takes hard work; be patient, understanding, and flexible; the first year can be tough; watch out for the seven-year itch.

Marriage sounds a lot like physician relations. The relationship may hit a rough patch. The dynamic may change: One day, you're wearing the pants, the next day you're asking for permission. The person who makes some days the brightest (or in a hospital's case, the most profitable) can make other days unbearable. You'll grow and change, develop new opinions and needs. And you'll have to figure out a way to accept each other and adapt--or face the possibility of a messy and expensive split.

It's tempting to believe that the cracks in the physician/hospital partnership lately have been the result of a changing market dynamic, and that good partnerships begin and end with the bottom line. But a new study by Press Ganey Associates reinforces the belief that the issues of most concern to physicians are more about communication and less about remuneration.

The report, Hospital Check-Up Report 2007: Physician Perspectives on American Hospitals, looks at the experiences of more than 21,000 physicians at 224 U.S. hospitals in 2006. Four of the top five physician priorities deal with communication between administrators and doctors.

The five factors affecting physician satisfaction are:

1. Response of hospital administration to physician needs and ideas
2. Patient care made easier
3. Administration deals with changes
4. Confidence in hospital administration
5. Communication with hospital administration

Of course, like marriage, there's a lot more to physician relations than communication. Facility type, specialty, physician age, and longevity of service can affect physician satisfaction. Physicians at acute care hospitals are much more satisfied than docs at specialty hospitals and academic medical centers. Surgeons, who often make the biggest impact on hospital revenue, are among the least satisfied physicians. Physicians over age 65 are significantly more satisfied than their younger peers, and doctors who've practiced at the same hospital for more than 20 years report greater satisfaction than those who have been with a hospital for less time.

How do you spot whether or not a physician is unhappy? According to the survey, referrals are a good way to gauge a physician's satisfaction: The more referrals, the more satisfied the physician. Physicians who refer less than 20 percent of their patients to a particular hospital are the least satisfied with that hospital.

Some hospital senior leaders may argue that marriages are actually easier than physician relations. The marriage contract, after all, is pretty clear, but with physicians, there's lots of gray. Physicians are part customer, part partner, part competitor. But before you launch into that joint venture on a physician office building, make sure the less expensive option of good communication has been played out to the end.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.