I absolutely love working with physicians even those who may be considered high maintenance. There was only one time in my entire healthcare leadership career when I wasn’t working with physicians, and quite frankly, I was bored to death. Physicians are highly intelligent, incredibly skilled, and very dedicated to providing excellent patient care. I have the greatest respect for who they are and for their many contributions. Physicians can also, at times, be challenging to work with, however, I assert that you may be a bit challenging too if you had patients’ lives at stake like they do. For me, it has been an honor and a privilege to work with physicians throughout my career, and I’ve very much enjoyed the relationships I’ve built and continue to maintain, even today after having left the healthcare field more than a year ago.
So, what is the secret to building effective relationships with physicians? I can only share what has worked for me. It is my hope that you will find something that resonates with you enabling you to build stronger, more effective relationships with your physicians. It all starts with taking the time to meet with each physician individually. When you, literally, have hundreds of physicians you are responsible for, it can definitely take a lot of your time but, I assure you, the return on your time investment will pay numerous dividends.
To begin, I like to take the opportunity to learn a little bit about the physician’s practice, what is working, not working and the challenges they are experiencing. Do they have the resources needed? Is the electronic health record working properly? If I inherit a medical or surgical specialty that I am unfamiliar with, I ask the physician to educate me. Trust me. The physician is only too happy to share expertise. Walking away from this initial meeting, my priority is taking care of whatever the physician needs. This may require downloading the issues to the physician’s immediate manager and/or lead physician. If it is an issue that needs my attention, it will be a top item on my priority list. This may seem fairly obvious but because we have such hectic schedules most of the time, things tend to fall through the cracks and, unfortunately, may never get addressed.
Secondly, I like to involve my physicians with decision making especially when it affects their clinical practice. A major frustration of physicians is when a decision is made that adversely affects their daily work flow. When changes are made that directly impact my physicians, timely communication, explaining the why for the change, is critical. Rounding on the physician’s to make sure things are running smoothly is another practice I like to do on a regular basis.
At times, I’ve encountered physicians who display unprofessional behavior. Rather than take a punitive approach, I like to meet with the physician first to find out what might be going on. I approach the situation assuming the physician is dealing with an unresolved issue and is just plain frustrated. Having an opportunity to talk through the issue with me is usually all that is necessary to diffuse the situation. And, having confidence that the issues will be handled in a timely manner also makes all the difference in the world.
As mentioned, one of my past leadership roles was leading a team to acquire medical group practices. While this particular practice acquisition was one of the larger ones we acquired, it wasn’t so much the size that made it so complex. It was its importance to the healthcare organization. This acquisition was for a very high profile cardiovascular group. As you can imagine, this acquisition would bring significant revenue into the organization. It took senior organizational leaders years to convince these specialty physicians of the benefits of becoming employed by the organization. The process of bringing this group into the employment setting was complex, highly visible and challenging. There was no room for error.
When the group practice administrator left as the acquisition process was about to begin, I was given the directive to partner with the physician president to ensure this acquisition went smoothly and was seamless for the physicians. I got the message. Nothing can go wrong, and it all started with building an incredibly strong relationship with the physician president who, by the way, did not have much trust for administrators.
The first time I met with the physician president, he wouldn’t even make eye contact with me. Part of this was cultural but a bigger part was his distrust. He shared his expectations of what the acquisition and integration process needed to look like and how he wanted it to go. I asked a lot of questions gathering as much information as I could. We met weekly, more often at first. I made sure he knew exactly what my team was doing every step of the way. After a couple of meetings and confident that things were getting done to his satisfaction, he started warming up to me. At one point, he said to me, rather emphatically, that no one from the organization was to enter his clinic to deal with affiliation details without my knowledge claiming he would literally throw them out. He didn’t want to deal with anybody but me. This was a very tough directive to enforce since there are many involved in the acquisition process, people from payroll, accounting, legal, business office, information technology and many other supporting departments. But he stuck to his directive, and if anyone showed up on his doorstep, out they went and were advised to contact me. While challenging to enforce, the good news was he was starting to trust me. After a few months, we actually became a pretty good team, and continued to meet regularly. I knew I was making progress with this relationship when I was even invited to meet with their “inner circle” physician leadership team, limited to a very few chosen ones and certainly not administrators. There was excellent communication, mutual respect and most importantly, trust between us.
The acquisition and system integration process took months but it went extremely well, a credit to my team and the strong relationship and partnership I was able to build with the physician president. After the group was on board and the process completed, the physician president asked me to stay on as their practice administrator. Can you believe it? From no trust to asking me to lead their group? I had no intentions of taking on this role because I was so fulfilled with doing practice acquisitions; however, he was so convincing that I finally took the position. A funny thing happened shortly after I assumed the administrator role. One of the long-term employees of this group said to me, “I just knew the president would ask you to stay on. I could tell how much he liked you. I could see the way he looked at you, talked about you, respected and trusted you.” I just couldn’t believe it. And, to think, it all started with building the physician relationship.