Five Lessons Learned on Influencing Physicians to Change
Raj Karnani, MD
Whether you’re a VPMA, CMO, or CAO, I’m sure you’ve been there. You’ve been given the responsibility to get practicing physicians in your group or hospital to change their work behavior for a quality improvement initiative. You trust that they know you and respect your position in the organization. And when you discuss a change, they nod in agreement, but they don’t follow through. Are you doing something wrong? Is your request unreasonable, or are you interfering with the physicians’ independence in practice? Probably not. So, where’s the disconnect?
There is no easy answer to getting physicians to change behavior. No easy answer. Period. However, you can do things to increase the chances they will accept change and make the necessary modifications. Below are five steps I’ve learned throughout my experiences that you can employ in your next quality improvement endeavor to increase the odds that you will affect positive change.
1. Use Data Instead of Opinion
First, I’m a data translator, so I understand the importance of making data relevant and understandable, and the value of respected data over opinion. Second, physicians are trained to evaluate and act upon data. Moreover, they are trained to be highly skeptical of things they hear, and with good reason – they want to avoid doing things to patients that aren’t necessary or harmful. Let’s say you want to get physicians to reduce their 30-day readmission rate for their patients in the hospital. If you tell them they need to improve, they will almost certainly disagree with you. If you can show them their 30-day readmission rate numerically, they will be much more likely to hear you out. Collect data regularly for your quality initiatives and be ready to show it.
2. Give it Time
Change rarely happens fast, and in a clinical setting, it will take considerable time to plan and execute. Something that seemingly takes a few weeks will probably take a few months. Make sure to account for this in your planning and adjust your expectations accordingly.
3. Focus on the Relationship
Physicians are more likely to listen to you if they trust and like you. The only way to build trust and likability is to spend time with them. Make sure to hear their concerns and show that you care. Once you have built up a high-quality relationship, it becomes easier to persuade them, and they will be more open to what you have to say. This process takes time, which highlights the importance of step 2 above.
4. Make Comparisons with their Peer Group
Physicians, by nature, are competitive people. Just think about what it takes to get into medical school, earn a high USMLE score, or enter a premier residency program. No physician wants to be at the bottom of his/her class. Therefore, when presenting performance data, show physicians how they compare to their peers. A physician who isn’t performing well compared to peers will likely be motivated to change. Just like in step 1, calculate comparison data regularly and have it handy to present to physicians.
5. Live What You Are Preaching
Nobody will be motivated to change if your peers can see that you aren’t doing it yourself. Let’s say you want to increase the percentage of times physicians wash their hands before seeing a patient. Be the example, and make sure to wash your hands before entering the room. Want to shorten your length of stay? Don’t be the one who needlessly keeps his/her patients in the hospital. Actions speak louder than words, and physicians will quickly point out your actions if they are not consistent with your comments. As a result, you will lose the ability to influence them.
Keep these five simple lessons learned in mind as you plan and coordinate your institution’s quality programs. If you do, you’ll become the person your colleagues seek out for guidance as they work to improve performance!
Dr. Raj Karnani is an academic physician and a healthcare analytics translator. His analytics expertise provides a foundation for healthcare organizations to appreciate and utilize advanced analytics (i.e., predictive modeling, machine learning, artificial intelligence), thus providing a more robust platform for planning and actions in population health management, value-based care, and clinical research.
Furthermore, with knowledge, experience, and training in medicine, clinical data science, medical education, and healthcare management, he bridges the gap that frequently occurs on analytics teams between IT professionals, who seek clinical experience, and key business stakeholders, who seek data science expertise, to enable them to work more effectively as a unit.
To this role, Dr. Karnani brings more than a decade of progressively expanding management and development accomplishments with documented successes improving both business and clinical outcomes. His corporate and organizational background includes CommonSpirit Health, IQVIA, and Michigan State University, and he can help your organization be more competitive with the right analytics. Dr. Karnani can be reached via email and through LinkedIn.