Managing Physician Relations for a Productive Practice

In the day-to-day operations of a small private practice or large hospital system, administrators are usually dealing with any myriad of issues that occupy their time, but many neglect one of the most important: managing physician relations.

"The one thing we have a key responsibility for is helping educate physicians … about the business side of the practice," said Kenneth T. Hertz, principal consultant for the MGMA Health Care Consulting Group. "That's a responsibility we have and if we don't do it, shame on us. A more informed partner is a better partner."

In his MGMA session “Managing Physician Relations for Retention,” Hertz addressed what he called common sense issues that many administrators know, but don't address, "because they are putting out fires all day."

Hertz linked managing physician relations to five key goals of any medical practice: satisfaction, productivity, safety, retention, and profitability.

"They are all interrelated," Hertz noted. "A happy doctor means happy staff means happy patients."

Hertz called satisfaction "critical" since it impacts a practice's bottom line. "If you fail [in terms of satisfaction], the domino effect is unbelievable." Satisfaction affects productivity, as well, he says, as unhappy staff and physicians can cause a ripple effect through organizations large and small.

On the serious issue of safety, Hertz said he hears skepticism from administrators and others, vowing that nothing interferes with safety, but he noted that when people are upset - about any aspect of their job - performance suffers and in healthcare that can present safety issues.

As for who bears the responsibility for managing physician relations, Hertz said it should be the goal of everyone at the practice, from physicians in leadership roles all the way down to support staff.

For administrators, Hertz said the tried and true style of "managing by walking around" is still relevant and is crucial to knowing what is going on with every aspect of a practice. Shutting yourself away from the day-to-day operations is no way to effectively gauge how a practice is functioning. Another key role of the administrator is following up on issues brought to their attention, whether it takes one hour or one year to resolve.

"This is an area where we fall down," he noted. "Let's say a physician comes to me with a problem … and after a while I have not communicated anything to him. The doctor assumes I can't be counted on. Getting back to people is an expectation we ought to fulfill."

As important as these aspects are in retaining talented medical professionals at your practice, Hertz said, they are also important to communicate while recruiting new doctors. That is the time for practices to state how they manage physician relations, express the expectations they have of new hires, and, perhaps most importantly, ask if a potential hire can meet those expectations.

"Sometimes we don't ask as many questions as we should," Hertz said. "We don't ask about expectations and later, that doctor leaves because what happened was not what they expected. There needs to be clarity and the expectations spelled out or, we say what the expectations are and we never ask [the doctor] if that is OK and if they are the same expectations they have."

Another key aspect of retaining and recruiting talented doctors, Hertz said, is communicating the culture of the practice during recruitment so you can assess a potential physician's compatibility with that culture.

On a related note, William Jessee, president of the MGMA, announced in a separate session that practice culture and its ties to financial issues is the subject of a forthcoming research project with the University of Minnesota. The two partners plan to issue their results on how culture can impact finances in early 2011.

Hertz also shared four important goals when managing physician relations: transparency (the importance of being upfront and honest with physicians); alignment (having common vision, values, and mission); engagement ("rather than a command and control" decree for physicians); and communications.

The latter is a skill needed by all administrators and includes using multiple strategies to reach physicians depending on how they best receive information.

"If you can't find a way to communicate with physicians, I don't know what to tell you," he said. "As for methods - make it easy for them. Use e-mail, text, notes, LinkedIn messages, YouTube videos … there are a 1,000 ways to do this, so use all of them."

Keith L. Martinis associate editor at Physicians Practice. He can be reached at keith.martin@ubm.com. 

For more of our coverage of the 2010 MGMA conference, visit www.physicianspractice.com/conference-insider/mgma2010.