How can organizations engage providers in improving care?

Marilu Bintz, MD, MBA, FACS; Vice President of Gundersen Health System in La Crosse, Wisconsin

I think you have to look at this through two sets of eyes. I think sometimes the organization says it’s hard to engage physicians because the organization approaches it from the standpoint of, “Doctor, I’m going to tell you what to do.” Well, doctors are trained to be pretty autonomous, and they’re pretty used to giving direction themselves. So the organization says, “Doctor, I’m going to tell you what to do,” and the doctor says, “No, really you’re not.” Well, that’s seen as lack of engagement. It’s just the wrong perspective. It is true that we as physicians are not trained in the real team approach that is so important in improvement today. That’s absolutely true, but that doesn’t mean that you can’t engage them through training, through learning.

The one thing that physicians are trained to do that is absolutely lined up with improvement methodology is PDSA. Every single day, doctors use PDSA in direct bedside patient care. That’s what bedside care is all about. When you engage physicians in improvement at the level of patient care, PDSA is like getting on a bike. They just get it, and they do it over and over again. So I think if the organizations understands that and leverages those talents, then you have engaged physicians. The physicians can’t help but engage because it comes so naturally to them. It’s just that we often approach this engagement topic from two divergent perspectives, when in fact, if we put them together, you end up with engaged physicians and organizational improvement, which then leads to direct patient care improvement. It works. It really does work.