physician engagement

Ramesh Sahjpaul MD , MScHead, Department of Surgery, Lions Gate Hospital

Co-Medical Director, Surgery Program, Lions Gate HospitalClinical Associate Professor, Division of Neurosurgery

Vancouver Coastal Health, UBC

Feb 20 2015, Quality Forum 2015, Vancouver BC

As Jauhur puts it, “American doctors are suffering from a collective malaise,” for reasons ranging from bureaucratic hassles to increased pressure to see more and more patients. Hence surveys showing that up to 40% of current doctors would choose a different career if they had to do it all over again, and even more say they would try to talk their kids out of a career in medicine. Physicians also tend to have unusually high suicide rates. According to the American Society for Suicide Prevention, male physicians commit suicide at a 70% higher rate compared with other professions, and female

https://www.afsp.org/preventing-suicide/our-education-and-prevention-programs/programs-for-professionals/physician-and-medical-student-depression-and-suicide/facts-about-physician-depression-and-suicide

An agreement to be married

An arrangement to meet or be present at a specific time or place

Emotional involvement or commitment




A hostile encounter between military forces




A hostile encounter between military forces

…..Sound familiar??

physician

X

A. Drive patient satisfaction ?


B. Drive improved patient safety ?



C. Drive improved quality of care ?




D. Drive reduction in costs ?





E. Drive improvement in operational efficiency ?





E. Drive improvement in operational efficiency ?

ANSWER: All of the above

Physician happinessPhysician engagement

In our best interest to get involved and engaged!

Pleasant, quiet, uninvolved ?

Loud and always negative?

Involved, critical yet constructive ?

CORE ASPECTS OF ENGAGEMENT

Collaborative

Shared vision

Requires patience

Working in the fuzzy areas Schedules

Budgets

Policies

CORE ASPECTS OF ENGAGEMENTCORE QUALITIES OF MOST PHYSICIANS

Collaborative

Shared vision

Requires patience

Requires accommodation

Working in the fuzzy areas Schedules

Budgets

Policies

Busy > lots of distractions

Lots of patients but not always a lot of patience

Limited knowledge of systems/budgets

Weary and cynical from years of being beaten down…

Fiercely independent…

Engagement is optional

No formal training in systems/institutional operations

*now increased recognition/support for leadership training

A lot going on

Credentialing overhaul

NSQIP

TPOTWait time targets/MOH deliverables

An engaging leader – preferably a physician colleague

-ie we’re on the same team…

Feedback – closing the loop

Win-win scenario

What’s in in for me?

For my patients?

An engaging leader – preferably a physician colleague

-ie we’re on the same team…

Feedback – closing the loop

Win-win scenario

What’s in in for me?

For my patients?

Leadership: Inspiring change through shaping belief

Can’t (easily) fire the bad apples…

In industry, 80% of success is firing/hiring…



We’re working with a tough crowd!

Imagine a hockey team full of Alexander Ovechkins!



We’re working with a tough crowd!

Imagine a hockey team full of Alexander Ovechkins!

Asking more and more of physicians’ time without compensation

LEADERSHIP ENGAGEMENT

Provide the mandate but not the tools

No leadership or top-down leadership

Tell people what they have to do but not why

Don’t listen to people

Don’t provide feedback

Don’t reward success

Value their time

Invest in leadership

Listen to their concerns

Tell them what you heard

Tell them what you’re going to do

Tell them what you did

Tell them again…..

OVERCOMMUNICATE…..

>> build a culture of trust one step at a time

NSQIP: 18-24 months before scepticism died down

TPOT: just starting…

Monthly quality council meetings (3 division heads)

Surgical Safety Checklist…a 2 year journey

Slowly but surely the Culture is changing

Avoid heavy-handed approach …. Can’t mandate engagement

Can’t do it alone…

physician engagement

Healthcare