How to Engage Doctors in the Healthcare Reform - Practical Advice from Cleveland Clinic CEO

CEO & President, Dr. Toby Cosgrove reflects on Engaging Doctors in the Healthcare Revolution:

From the article in Harvard Business Review ( "Fixing health care will require a radical transformation, moving from a system organized around individual physicians to a team-based approach focused on patients. Doctors, of course, must be central players in the transformation: Any ambitious strategy that they do not embrace is doomed.

And yet, many physicians are deeply anxious about the changes under way and are mourning real or anticipated losses of autonomy, respect, and income. They are being told that they must accept new organizational structures, ways of working, payment models, and performance goals. They struggle to care for the endless stream of patients who want to be seen, but they constantly hear that much of what they do is waste. They’re moving at various rates through the stages of grief: A few are still in denial, but many are in the second stage—anger. Bursts of rage over relatively small issues are common."

How to move forward?

The authors suggest a framework based on the writings of the economist and sociologist Max Weber, who described 4 motivations that drive social action (that is, action in response to others’ behavior). Adapted for health care professionals, these are:

- shared purpose
- self-interest
- respect
- tradition

"Leaders can use these levers to earn doctors’ buy-in and bring about the change the system so urgently needs.

Sometimes the story of a single patient is enough to galvanize doctors’ buy-in. In 2008, for example, a patient called the Cleveland Clinic’s urology department seeking an appointment because he was having trouble urinating. He was given the next available slot—two weeks away. A few hours later he arrived in the emergency department with acute urinary retention. Doctors quickly solved the problem, but the patient suffered greatly in the hours before treatment.

As a result, the clinic instituted a same-day appointment policy whereby all patients who call are asked whether they want to be seen immediately. About one million of the 5.5 million visits a year now occur on the same day the patient calls. This policy occasionally disrupts physicians’ schedules, but the new system is comforting to patients, and clinic doctors have come to embrace it."

A longer video overview of the topic: Engaging Doctors in the Healthcare Revolution:


Engaging Doctors in the Health Care Revolution - HBR

Disclosure: I am an Allergist/Immunologist at Cleveland Clinic.

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