To improve hospital-physician relationships, involve docs in decision-making

Healthcare leaders who want support from their physicians must step up efforts to involve them in key decisions, according to an opinion piece in Forbes.

"No longer can administrators rely on support for decisions in which the physicians had no real input," wrote Josh Weisbrod and Tim van Biesen, New York-based partners in the business consulting firm Bain & Company's healthcare practice.

The piece follows the recent publication of the American Medical Association and the American Hospital Association's guiding principles to help balance clinical and business concerns. 

The physician-healthcare organization relationship has historically been contentious, and those tensions may only get worse, Weisbrod and van Biesen wrote. A national Bain survey, "Front Line of Healthcare Report 2015," of 632 physicians across different specialties and 100 hospital procurement administrators in the U.S., reveals the extent of the divide between the two groups. While many procurement departments focus on reducing costs, physicians worry about the adverse affect on quality of care.

At the heart of the issue is how healthcare is paid for, how physicians make decisions and deliver care, and how organizations purchase and use drugs and devices, the authors said. Tension between healthcare organizations and their physicians could lead to a slowdown or reversal of physician employment trends and battles over which devices physicians can use and which drugs they can prescribe. The friction comes at a time when the number of independent physicians is on the decline and more are going to work as employees of healthcare organizations.

In the Bain & Company survey, 40 percent of surgeons said they no longer use a product because it is not on a preferred list at the hospital where they work. And 65 percent of office-based physicians said drug formularies limit their decisions about what medications to prescribe, with more than half saying those limits constrain their ability to provide quality patient care. While two-thirds of surgeons said they felt pressure to comply with hospital purchasing guidelines, only half of procurement officers believed surgeons were pressured to cooperate. The two parties also disagreed about the importance of price in purchasing decisions, with 53 percent of surgeons believing lowest price should be an important or very important purchasing criterion, compared with 72 percent of procurement officers.

Along with involving physicians in decision-making, healthcare administrators should create partnerships with vendors who can share best practices about their products, the two authors said. While better communication can help mend relationships, there must also be meaningful action and follow-through. Dissatisfied physicians, once unwilling to recommend their organizations to others as a workplace, reversed their opinions significantly when organizations inspired them with the institution's mission and values, and engaged them in decision-making, according to Weisbrod and van Biesen.

To learn more:
- check out the opinion piece
- read the report on the survey