1. Building Better Physician Relationships

2. I. Operational Concerns II. Physician Needs & Wants III. Organizational Needs IV. Ways to Improve relationships V. Recommendations VI. Closing Thoughts

3. Operational Concerns Practice style: Practice style: patient flow patient flow 20 pts/day 20 pts/day 18 pts/day for internal medicine & private practice 18 pts/day for internal medicine & private practice visit time (Pros & Cons): visit time (Pros & Cons): 15 min (current pts) 15 min (current pts) 30 min (new pts) 30 min (new pts) “bedside manners” “bedside manners” Empathy towards pts. Empathy towards pts. Positive communication Positive communication Body language & posture Body language & posture Active listening Active listening

4. Operational Concerns Changes in work ethic: Changes in work ethic: Timeliness Timeliness Visit times Visit times JCAHO requirements JCAHO requirements Etiquette: Etiquette: Professionalism Professionalism Effects on operations Effects on operations pt/physician relationships (role models) pt/physician relationships (role models) Control: Control: patient panels patient panels

5. Physicians’ Wants & Needs: Geographical locations Geographical locations Control of patient panels Control of patient panels More staff to meet admin. demand on pt caseloads More staff to meet admin. demand on pt caseloads Compensation Compensation salary incentives (bonuses), Pay for performance salary incentives (bonuses), Pay for performance Time Time Minimize info. Overload Minimize info. Overload Increase visit times Increase visit times Equipment (technologically driven tools) Equipment (technologically driven tools) BP Machines BP Machines Tablets, etc. Tablets, etc.

6. Organizational needs Efficient / productive Efficient / productive Advocates / teachers Advocates / teachers Leaders & role models Leaders & role models “Champions of The Cause” “Champions of The Cause” For change and better pt care For change and better pt care

7. Ways to improve relationships: Interact & listen Interact & listen Give a productive platform for open discussion Give a productive platform for open discussion Provide clear, concise and permanent follow up to their concerns Provide clear, concise and permanent follow up to their concerns Validate MD concerns and issues Validate MD concerns and issues

8. Ways to improve relationships: Staffing: what is the appropriate staff mix Staffing: what is the appropriate staff mix Physician to staff ratio (avg mo.pt flow/total mo. Hrs. or national benchmark 3:1) Physician to staff ratio (avg mo.pt flow/total mo. Hrs. or national benchmark 3:1) LVN, RN, Nurse tech, etc… LVN, RN, Nurse tech, etc… Involve physicians in business side operations Involve physicians in business side operations Provide understandable practice analysis reports to show PCP performance & how it influences bottom line Provide understandable practice analysis reports to show PCP performance & how it influences bottom line Provide a list of updated pt panels ( manage caseloads) Provide a list of updated pt panels ( manage caseloads) Increase physician presence in executive & boardroom discussions Increase physician presence in executive & boardroom discussions

9. Ways to improve relationships: Create Awareness: Create Awareness: Communicate mutual goals & objectives between administration and physicians Communicate mutual goals & objectives between administration and physicians Training: Training: Offer training and coaching techniques for providing better communication & customer service Offer training and coaching techniques for providing better communication & customer service Improving communications: Improving communications: Provide resources to support the change process by disseminating info. & enhancing awareness Provide resources to support the change process by disseminating info. & enhancing awareness

10. Recommendations: 5 Point Relationship Building Plan: 5 Point Relationship Building Plan: Reliability Reliability Dependable and accurate performance Dependable and accurate performance Assurance Assurance Be knowledgeable and courteous; inspire trust and confidence Be knowledgeable and courteous; inspire trust and confidence Tangible (evidence of change) Tangible (evidence of change) Personnel Etiquette Personnel Etiquette Empathy Empathy Provide individualized attention between physician, administrators, and staff Provide individualized attention between physician, administrators, and staff Responsiveness Responsiveness Willing to help and provide prompt service Willing to help and provide prompt service

11. 5 Point Relationship Building Plan Reliability: Reliability: Deliver a service as promised (administrative, medical, & support staff functions) Deliver a service as promised (administrative, medical, & support staff functions) Use good judgment to determine best course of action when requesting a service & voicing concerns Use good judgment to determine best course of action when requesting a service & voicing concerns

12. 5 Point Relationship Building Plan Assurance: Assurance: Be Credible Be Credible Communicate needs & expectations Communicate needs & expectations Build trust Build trust Be confident Be confident

13. 5 Point Relationship Building Plan Tangible (physical evidence of change): Tangible (physical evidence of change): Etiquette: Etiquette: Social Behavior Social Behavior Professionalism Professionalism Employee interactions Employee interactions

14. 5 Point Relationship Building Plan Empathy: Empathy: Pay attention Pay attention Actively listen Actively listen Adapt Adapt Be flexible Be flexible Build rapport Build rapport

15. 5 Point Relationship Building Plan Responsiveness: Responsiveness: Willing to help each other solve tasks Willing to help each other solve tasks Responding promptly to requests Responding promptly to requests Giving updates Giving updates

16. How to implement the 5 point plan FromTo Role Customer-for information, evidence and reports form others Supplier-of information, expertise and other services Strategy Control-by imposition of policies & procedures or by audit & inspection Coach on the latter but Support-by gearing efforts to the needs of others Goal Departmental-achievement of dept. objectives Collective achievement of the organization’s objectives Work relations Competitive, adversarial Integrating, collaborative Focus of attention Quality, financial results, adherence to policy & procedure relationships between the entire service delivery process & achievement of desired outcomes Image Regulator, inspector, “policeman” Educator, helper, guide From Hutton, D.W (1994).The Change Agent’s Handbook: A survival Guide for Quality Improvement Champions pg 220 Copyright © 1994 by David W. Hutton; The Six Sigma Handbook: A Complete Guide to better Black Belts: Green Belts; & Managers of All Levels. pg 20 © by Tomas Pyzdek

17. Closing Thoughts