Why is it so difficult to engage physicians?

One way to analyze this question may lie in exploring the dual meaning of the word engagement.  The yang, or positive aspect, involves interfacing with another person in a pleasant fashion, as in, “She engaged him in conversation,” or “They are engaged to be married.”  The yin, or negative polarity, involves entanglement and conflict, as in “our army engaged the enemy.”

In “Mending the Gap Between Physicians and Hospital Executives,” (Cohn KH and Hough D., The Business of Healthcare Westport:Praeger, 2007, Greenwood Publications, Inc.), Deane Waldman and I wrote that over the past 50 years, advances in care have changed the jobs of healthcare professionals substantially.  Blood-banking, heart surgery, and antibiotics were in their infancy, and CT scans, minimally invasive surgery, and the Internet were not standard of care.

Unfortunately, our systems of care do not seem to have progressed as rapidly, especially with regard to healthcare delivery.  As Maggie Mahar wrote in Glenn Beck Gives Birth to a New Health Care Myth, “the behavior of health care professionals is inextricably linked to the health care system in which they work. Granted, it’s not as though there’s a simple, direct line from institutional design to the hearts and minds of doctors; but systems set incentives and define interests that ultimately encourage, reward, or penalize certain behavior.”

I hope that this blog will serve as an eventual repository of results of experiments that improve delivery of services, decrease waste, and help people reconnect with the reasons that they chose healthcare careers in the first place.

If physicians and other healthcare professionals agree on the who (patients) and the why (to make a positive difference in patients’ lives), the how becomes a life-long learning journey.

How do you see it:

• in what ways can the common frustrations of being squeezed by stagnant or decreasing reimbursement in the face of rising expectations and burdensome regulations unite us rather than divide us
• What can physicians learn from hospital leaders about building consensus and safeguarding organizational survival
• What can hospital leaders learn from physicians about making high-stakes decisions in the face of limited information and limited time
• How can both groups learn to work together and not personalize inevitable disappointments?