ATLANTA - While improving your communications effort with physicians should be on your internal communications agenda, it's probably not high on the priority list, according to a recent study.

Doctors generally give only fair or poor ratings to their hospitals for keeping them up-to-date, listening and responding to their needs and ensuring they have a meaningful strategic role within the organization. Findings from the study were revealed by Kathy Lessor, director of corporate communications for Premier hospital alliance, during the annual conference of the Society for Healthcare Strategy and Market Development recently held here.

Ironically, CEOs and chief medical officers see it differently. Three-fourths of them think their hospitals/systems do a good or excellent job of ensuring physicians a meaningful organizational role and none of them gave their hospitals "poor" ratings in listening/responding to physician needs.

Physicians and CEOs agree that a lack of trust between physicians and administrative staff is a major stumbling block to developing successful relationships, and they believe improved communications builds trust. The study also found that leaving physicians out of organizational planning is a sure-fire way to sabotage relationships.

Premier, an Oak Brook, Ill.-based hospital alliance that's owned by more than 240 healthcare systems and represents another 1,100 affiliated hospitals, conducted the 18-month study to determine strategies for building successful relationships.

"Physician involvement has to be real, ongoing and begin at the earliest stage of hospital/system decision making," Lessor said. "Telling physicians about decisions already made or plans that are nearly final is no substitute for having the physicians involved in the planning and decision-making process from day one."

Lessor noted some hospitals have developed programs with measurable results. For example, St. Francis Health System in Honolulu has a four-step program that includes: extensive rounds of large and small group meetings to which physicians and their spouses are invited; identification of communication barriers; small task forces of physicians and administrators who address each barrier; and a development of a process to communicate with physicians about the barriers and the steps being taken to address them.

The program already has resulted in the hospital improving its process for peer review, cutting credentialing time from six months to 30 days and resolving operating room scheduling problems.

Hospital or system chief executive officers who commit to regularly meeting with physicians and formally solicit their opinions can greatly improve efforts to integrate delivery networks and help with patient retention, she said.

"Your doctors are your most important asset," said Lessor. "They are a conduit to your customers."

Others agree.

"Some of the messages managers have to send to physicians are pretty tough," said Helen Meldrum, Ed.D., associate professor of psychology and commun-ication at the Massachusetts College of Pharmacy and Allied Health in Boston.

"You're calling and you may be recommending a change of some kind. And you're not quite sure how your advice is going to be received."

Meldrum teaches her students to use the CLEAR system to organize messages to physicians. The system explains an approach communicators can take to "clearly describe" the problem to the physician, "listen" to what the physician has to say, "express" concerns, "assert" yourself and seek "results." This approach comes out of language theory and the discipline of assertiveness training, says Meldrum.

On-the-job training helps, too. Experienced communicators say diplomacy is the operative standard when contacting a physician.

Other key findings of the survey of 100 hospital/system CEOs and physicians include:

  • A commitment to physician communications must be long-term and come from the top of the organization-the CEO, board and administrative staff.
  • There must be formal mechanisms established with the hospital/system for seeking physician input and opinion. This would include having doctor representatives on all executive boards.
  • Hospitals and systems must measure the effectiveness of their communications to physicians, particularly given the differences in perceptions of administration and physicians.
  • Nothing can substitute for personal, face-to-face communications. CEOs should walk around their facilities, know physicians by their first names and listen to their concerns. The study also showed that written communications, such as newsletters and memos, are least effective with physicians.
  • Physicians also must be held accountable for providing input to decisions and for making hospital-physician communications work.

(Premier, 708/409-4112)