Sometimes hospital system executives and physicians seem to operate on different planets.Chief executive officers and group physicians often disagree about how well they are communicating. More disturbing, the communication methods deemed most effective aren't commonly used.
Those are some findings in a groundbreaking study of communications between physicians and hospitals by Premier, a hospital purchasing alliance."Some of these things that seem so obvious aren't being done," said Kathy Lessor, director of corporate communications for Premier. "It obviously strikes a nerve."
Last year Premier surveyed its member CEOs and found their No. 1 communications concern in the area of network integration was physicians.
There was little research to go on, so Premier set out to find ways in which hospitals and physicians can communicate more effectively. First, it surveyed 50 CEOs and 50 physicians, half of them chief medical officers and half rank-and-file group physicians. Also polled were public relations directors and physician services directors, referred to in the survey as communications directors. It turned out CEOs were far more satisf ied than physicians.
Most group physicians gave fair or poor ratings to the current efforts of their hospitals in keeping them up to date, listening and responding to their needs, and ensuring they have a meaningful role in setting strategy.
Only 16% to 20% of CEOs felt hospitals were doing a fair or poor job in those areas.Group practice physicians were more likely than chief medical officers to rate communication as fair or poor.
Sixty percent of group practi ce physicians said they want more involvement in decisions, but generally they don't want to sit on time-consuming boards and committees. Rather, they want their opinions to be sought out and considered.
CEOs and physicians concurre d that the most effective communication method is one-on-one meetings between physicians and hospital executives. General medical staff meetings and newsletters, which are most commonly used, were deemed less effective.
Communications directors weren't in sync with these sentiments. In fact, they deemed general medical staff meetings and newsletters to be most effective.
Premier's second task was to look for examples of organizations that were doing it right. It found a wide range of effective communication tactics, from a weekly "Dear Doctor" letter from Mitchell Rabkin, M.D., president of Beth Israel Hospital in Boston, to a biannual meeting of past medical staff preside nts at St. Patrick Hospital in Missoula, Mont., to a comprehensive leadership training program at Borgess Health Alliance in Kalamazoo, Mich.
Key to success, Premier said, is long-term effort and commitment from the CEO and the board.
Heartening was the fact that the simplest, most basic tactics, such as personal letters and town meetings, still work. In other words, there is no need to throw an expensive medical staff banquet where doctors sit and listen to oral reports.
On the other hand, some emerging high-tech systems, often shunned because they might alienate older physicians, can be efficient tools, the study said. Florida Hospital in Orlando reported success with a computer softwa re system that linked hospitals and physician practices.
The trick, Premier said, is to avoid relying on any one tactic and instead select a variety.
However, all these conclusions are just a start, Premier admits. Best practices in hospital-physician communications are few, since hospitals haven't measured the effectiveness of physician communications as they have consumer communications. A variety of tactics are in place, but there's little consensus on what works best.
The best practices in the study were determined by word of mouth and anecdotal evidence, rather than empirical study.
"One of the likely values of our study was to point out some areas of possible research and also to suggest to hospitals they not make assumptions about physician groups or assume all physicians have the same communication needs, but to do some research within their own organizations," Lessor said.