Physician Culture and Engagement

I will no longer be the Chief Medical Officer (CMO) for Specialty Medical Partners. And by that, I mean I’m getting a new title. The reason I was the CMO in the first place was that I got to pick my own title, and join the team of Chief Executive Officer, Chief Financial Officer, and Chief Operations Officer. So, ‘Chief Medical Officer’ seemed to make sense. However, what I have found out since then is that CMO is a well-defined job description, especially in the United States.

There are parts of the CMO job description that I fully agree with, and wish to continue:
• Take a leadership role with the team to promote patient care.
• Act as a liaison between physicians and leadership through open communication and transparency.
• Encourage physician engagement and development, including recruiting and mentorship.
• Help to ensure regulatory compliance and accreditation standards.

However, the primary role that the CMO is supposed to play is ‘clinical oversight, including enforcement of clinical protocols’. I do not want to dictate or micromanage how a physician treats their patient. I believe that the business management side of running a medical practice should free up the MD to do what they do best: try to help the patient in front of them.

My new title will be the less impressive sounding “Director of Physician Engagement”, shortened from the unwieldy “Physician Culture and Engagement Manager”.

What is Physician Engagement?
Multiple studies have shown that physicians are highly immersed in their day-to-day work (i.e. patient care) but may feel disconnected from their workplace as a whole, be it a small office, large group clinic, or hospital1. Physician engagement refers to regular participation of MDs in deciding how their work is done, making suggestions for improvement, and goal setting2.
The ultimate endpoint is to create a set of positive work attitudes, behaviours and environments (“culture”) that benefits the patient, the physician, their colleagues and the entire health care system. In a cross-Canada survey of physicians, some of the top reasons for not participating in leadership activities were: they were never asked, no support, and bureaucracy1.

Why is Physician Engagement Important?
Physicians who feel supported and know that their input matters are more likely to collaborate effectively with peers, leading to better patient outcomes and a more cohesive healthcare team. Creating a supportive environment for MDs requires a multifaceted approach that can be implemented in any organization, from a small clinic to a hospital network.

How to Encourage Physician Engagement?
1. Leadership commitment: Leaders must demonstrate a genuine commitment to physician well-being and promote a culture of transparency and respect.
2. Open communication channels: Allow physicians to voice concerns, provide feedback, and contribute to the decision-making process through scheduled all-hands meetings, feedback surveys and regular one-on-one sessions.
3. Recognition and appreciation: Recognizing MDs for their contributions reinforces a culture of appreciation and motivates continued excellence.
4. Work-life balance initiatives: Leadership can bring in policies such as flexible scheduling, and access to benefits such as counseling services.

A title change from ‘Chief Medical Officer’ to ‘Director of Physician Engagement’ may not mean much in the grand scheme of things, but I think that it’s indicative of what the business side of medical practice should be doing: encouraging a positive culture of physician engagement without dictating how each MD sees fit to help their patients.

Author: Dr. Krishna Sharma, Chief Medical Officer, Specialty Medical Partners

References:
1. Perreira TA, Prokopy M, Shea C, et al. Physician engagement, well-being, and organizational culture. Ontario Hospital Association 2021. https://www.oha.com/Bulletins/Paper%205%20-%20Report.pdf
2.Perreira T, Prokopy M and Harel T. What do we really mean by “physician engagement”? Canadian Society of Physician Leaders Vol 6 no 2. https://cjpl.ca/engp.html#edittop