Ramesh Sahjpaul MD, MSc Head, Department of Surgery, Lions Gate Hospital Co-Medical Director,...

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

Physician Unhappiness…A global phenomenon

What is engagement?

An agreement to be married

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

Emotional involvement or commitment

What is engagement?




A hostile encounter between military forces

What is engagement?




A hostile encounter between military forces

…..Sound familiar??

physician

X

Why is physician engagement so important?


A. Drive patient satisfaction ?


A. Drive patient satisfaction ? B. Drive improved patient safety ?


A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ?


A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ? D. Drive reduction in costs ?


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 ?


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 ?

ANSWER: All of the above

Physician happiness

Physician engagement

In our best interest to get involved and engaged!

Could you recognize the engaged physician?

Pleasant, quiet, uninvolved ?

Loud and always negative? Involved, critical yet

constructive ?

So why is it so hard to engage physicians??Physician factors

CORE ASPECTS OF ENGAGEMENT

Collaborative Shared vision Requires patience Working in the fuzzy areas

Schedules Budgets Policies

So why is it so hard to engage physicians??Physician factors

CORE ASPECTS OF ENGAGEMENT CORE 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…

Sounds cliché but…we are in this together…

Why are physicians disengaged?External factors

Engagement is optional No formal training in systems/institutional operations

*now increased recognition/support for leadership training A lot going on

Credentialing overhaul NSQIP TPOT

Wait time targets/MOH deliverables

(Sustained)Engagement requires

An engaging leader – preferably a physician colleague-ie we’re on the same team…Feedback – closing the loopWin-win scenarioWhat’s in in for me? For my patients?

(Sustained)Engagement requires

An engaging leader – preferably a physician colleague-ie we’re on the same team…Feedback – closing the loopWin-win scenarioWhat’s in in for me? For my patients?

Leadership: Inspiring change through shaping belief

Challenges for physician leaders in health care


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

How to guarantee failure in

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

Physician engagement ‘formula’

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

Lions Gate HospitalSmall successes…

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…

Ramesh Sahjpaul MD, MSc Head, Department of Surgery, Lions Gate Hospital Co-Medical Director,...

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