Doctors Feel Excluded from Health Care Value Efforts, Survey Shows

Physicians understand the financial challenges, but many don’t think they are in a position to help rein in health care rising costs.

U.S. hospitals and health care groups have experimented over the past decade with new management structures and alternative payment models to provide quality health care at lower cost. But physicians have been slow to embrace these for a host of reasons. Chief among them, our research shows, is that they feel excluded from the process.

The only practical way to make value-based care a reality is for health care organizations to bring physicians back into the decision-making process.

With our colleagues at Bain & Co., we recently surveyed  980 U.S. physicians as well as 100 health system procurement officers — the people in charge of buying supplies for hospitals. What we found was startling: Physicians clearly understand the challenge posed by rising costs for clinical care and prescription drugs, but many don’t feel they are in a position to help rein in costs. Rather, they do not feel sufficiently engaged in making important decisions about cost control, performance improvement and adoption of new reimbursement models.

RELATED: Survey: As C-Suite Pay Rises, Physicians Poised to Lead Health Care Changes

By sidelining doctors, the health care industry has overlooked a key principle in change management: Physicians who are not aligned and engaged with their organization have more reasons to resist new systems, while those who are engaged in decision-making are much more satisfied with the working environment and willing to lead change.

Physicians are particularly hesitant to embrace new systems when the clinical implications and the return on investment are unproven and the administrative burden is significant. More than 70 percent of physicians told us they prefer the traditional fee-for-service payment model, citing concerns about the complexity and quality of care associated with value-based models.

The evolving role of physicians in the purchase of medical equipment, however, highlights the kind of collaborative approach to decision-making that could help create a more supportive climate for value-based care. Many hospitals in the United States have recently been giving surgeons a bigger say in medical-equipment purchasing. More than 80 percent of surgeons and procurement officers told us they now work in collaborative partnerships to purchase medical equipment, weighing clinical and economic value together, and surgeons broadly support this arrangement.

RELATED: Purposeful Leadership: When the Bottom Line Includes Ethics and Vision

Giving physicians a greater say increases their commitment to change. When we asked physicians if they would recommend their organization as a place to work and practice, we found a 108-point difference (47 percent vs. minus-61 percent) between those who said they were highly engaged in decision-making and those who were not.

Health care organizations can generate greater support for value-based care by working closely with their physicians to shape these models and addressing doctors’ concerns about implementation and outcomes. It will take time to develop clinical and economic evidence, which means the pace of change will remain slow. But it will also help the industry move toward better solutions.

Tim van Biesen is a partner in Bain & Co.’s health care practice. Josh Weisbrod is a partner in Bain & Co.’s health care practice.

Copyright 2017 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.

Topics: Management

Even Doctors Can’t Navigate Our ‘Broken Health Care System’
Coach’s Corner: Recognition Is the First Step to Change
Advertisement
Online Courses - Transition from Leadership to Management

Popular Articles

Advertisement
Fundamentals

About Physician Leadership News

Now more than ever, physicians are leaders in their organizations and communities.

The American Association for Physician Leadership maximizes and supports physician leadership through education, community, and influence. We promote thought leadership in health care through our Physician Leadership News website, bimonthly Physician Leadership Journal and other channels.

We focus on industry leadership issues such as patient care, finance, professional development, law, and technology. Association announcements and news of association events can be found.

Send us your feedback at news@physicianleaders.org.


Journal Submission Guidelines

AAPL's award-winning print publication, the Physician Leadership Journal, welcomes originally authored manuscripts for peer review that meet competency, formatting and preparation criteria. To review these guidelines and other information regarding submissions, click here.