Physician Engagement: Barriers and Strategies

Physicians are a crucial element of our health care system. They are on the frontlines, not only directing patient care, but also implementing many of the system changes we need to improve care and achieve greater efficiencies. Efforts to increase access, quality, and value in the health care delivery system hinge on physician buy-in – making physician engagement a top priority for many of Aurrera Healthgroup’s clients.Meaningful and successful physician outreach requires an understanding of the many challenges and concerns that physicians consider when asked to participate in the implementation of new health care programs.  Through our work on state delivery system reform incentive payment (DSRIP) programs, California’s Coordinated Care Initiative, and other health care transformation projects, we have gained experience with the common barriers to effective physician engagement and have developed successful strategies to address them:

Potential Physician Engagement Barriers

Gatekeepers

Physician practices often have gatekeepers responsible for guarding their physicians’ and office staff’s time. The gatekeeper, often administrative or front desk staff, are often the first barrier an outreach team will encounter when attempting physician outreach. Demonstrating the value of the program to the gatekeeper is important to achieving an audience with a physician.

Delivery System Reform Fatigue

In this time of dramatic changes to our health care system, it can be a challenge for physicians to understand their role, how the changes will impact them, and how best to implement the latest programs or regulations. Physicians may perceive new programs as a threat to the way they are used to delivering care to their patients, and fear the loss of autonomy and revenue. In addition, physicians near the end of their career may not be as invested in long-term changes and wary of new technologies.  These physicians also are more likely be dependent on the traditional service and payment models that are often the target of delivery system reform efforts. The combination of these changes can produce delivery system reform fatigue.

Limited Resources

Physicians often fear that delivery system reform will increase their administrative burdens and reduce the time they have to spend with patients. Additionally, physicians may be concerned that they will be required to invest in new technologies and/or to dedicate staff time to reporting or participation in care teams – without being guaranteed that those investments will pay off in better care or outcomes for patients. When faced with limited resources, physicians often prefer to focus on direct patient care delivery.

Effective Physician Engagement Strategies

Have an Informed Plan and Strategy

Build a plan and use it to develop your physician engagement strategy:

• Define your goals and objectives.
• Consider what physicians need from you (i.e. why should they engage with you), what value your message and the new program brings them, and what questions they might have.
• Ask physicians for their thoughts, concerns, needs, and questions. This can be done by establishing physician workgroups, adding them to existing groups, conducting physician focus groups, meeting with physician leaders, and/or soliciting feedback during planning stages, policy development, and/or ongoing stakeholder engagement.
• Use these insights to develop your engagement strategy.

Support Physicians

Physicians have limited time and need help understanding policy, programmatic, and system changes.

• Meet physicians where they are and provide consistent, succinct, clear, and informative support without overwhelming them. It is important for the physician to see you as a partner with valuable information and not as an agent forcing change or casting blame.
• Work with physicians to identify and address misconceptions, needs, concerns, and questions. Use their feedback to adjust your strategy and messaging as necessary.
• Look for common goals and value propositions to help build positive relationships.
• Create materials for physicians to refer to and to use to educate patients.
• Engage with office staff, especially the office manager, as an effective way to get your message to the physician or to get resources to the practice.

Leverage Relationships

Reaching physicians is more efficient and effective when you can leverage existing networks, relationships, and physician champions to open doors and make introductions.  A referral from a colleague or a respected member of the medical community is one of the quickest ways to reach a physician.  Referrals can provide automatic credibility.

• Ask what other physicians you should talk to and for an introduction or endorsement.
• Educate patients and encourage them to speak to their physicians
• Maintain good relationships with physicians and other valuable partners as you implement your strategy, as they may open other doors in the future.
• Work with the physician’s staff to create leverageable relationships, as they often influence the physician.

 Read more from our outreach series:Part One of Three: Do’s and Don’ts of Effective Physician Outreach