Step 5: Invest in Medical Staff Leadership
Leadership is a developed set of competences that includes behavioral attributes, knowledge, skills and tools that enable an organization to effectively and continuously adapt to changing internal and external environmental requirements. Physicians do not learn about or develop the requisite leadership competencies as part of their medical education, and this is reflected by the cultural conflict between medical staffs and hospital administrations. Some further thoughts show that the leadership challenges for physicians include:
Step 6: Invest in Social Capital
Social capital is characterized by the networks, processes and trust that help to facilitate coordination and cooperation for the benefit of individuals that are part of a larger group. Physicians and hospitals form a social unit. The strength of relationships and good will that comes from physicians, administrators and boards spending time together in social activities both in and away from the hospital can be enormous.
Step 7: Hold Regular Meetings and Retreats
Successful relations are characterized by the development and implementation of multiple points of structured access between physicians and hospital. The following are some examples of best practices seen in organizations that might serve as examples to others. These include:
Step 8: Establish a Written Conflict Resolution Mechanism
Because of significant fundamental differences, conflict is inevitable even under the best of circumstances. A process for resolving conflicts between physicians and hospitals must be planned and agreed upon by both parties in advance of any conflicts. A formal policy should identify the process that shall occur and the leadership tools to bridge the gap.
Step 9: Maintain Excellent Communication
Communication is the active process of exchanging information and ideas. An excellent communication process needs to be planned, open and frequent. Communication competencies need to be learned, practiced and implemented. Those competencies include:
Step 10: Celebrate the Successes
The journey to improving physician-hospital relations can be long and arduous. In fact, at times it can be downright contentious. But along the way, some short and long term wins have been realized. Some of the successes to celebrate include:
Summary and Conclusion
This monograph has outlined a ten step approach developed by The Greeley Company to improve physician-hospital relations. The monograph began by keeping the end in mind. What would it look like after the multi-year process necessary to achieve different results? Let's take a look:
Step1: Acknowledge physicians are customers, partners and competitors. Physicians and hospital now have a better understanding and appreciation that the old social contract between the parties has expired and conversations about a new order can begin.
Step 2: Heal the past. Physicians and hospitals have been able to name perceived past injuries and have agreed not to play old tapes. This has allowed the physicians and the hospital to begin to work through the dynamic of impact and intent. Because of this, the healer's wounds have been acknowledged and the past can be appropriately mourned. An emerging light from this storm is that a rediscovery of the "joy of medicine" is occurring.
Step 3: Create a shared vision of mutual successes. The medical staff and hospital, having each crafted their own mission/vision statement and a joint strategic plan that is multi-tiered and flexible.
Step 4: Develop mutual expectations for physicians and the hospital. The physician-hospital "compact" has served the parties well in focusing, aligning and advancing the diverse groups in search of their mutual interest to provide better and expanded clinical care to patients and communities.
Step 5: Invest in medical staff leadership. The formalized Medical Staff Leadership Institute, with its delineated application procedures, formal curriculum and criteria for advancement, has graduated its third class of present and future physician leaders.
Step 6: Invest in social capital. Physicians and hospital have increased play together and now have a harder time fighting than those who don't.
Step 7: Hold regular meetings and retreats. Increased trust has definitely grown from structured access.
Step 8: Establish a written conflict resolution mechanism. The written conflict resolution process and the investment in training all leaders in both principled negotiation and Polarity ManagementT have helped guide physicians and hospital through multiple conflicts.
Step 9: Maintain excellent communication. Active listening has become the norm. In seeking to first understand, the parties are now are finding that they are being understood.
Step 10: Celebrate the successes. Along the way, successes were identified and celebrated in public ceremonies recognizing the change agents and minimizing the naysayer.