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The Myth of the Independent Physician

October 2, 2019

Human nature inspires us to create myths in the face of misunderstanding: to a sailor, a manatee becomes a mermaid and an elephant skull becomes cyclopean remains. And while independent physicians are very much not mermaids, the myths surrounding them nonetheless damage perceptions and relationships.

Many hospital leaders worry that they’ll never fully engage or align these physicians with healthcare network efforts. Further, they worry that independent physicians have lackluster interest in consistent referrals to a given system, and remain difficult to engage even if they become employed. To many frustrated leaders, these physicians feel unreachable—both physically as some practice across town, and emotionally, seeming very much like a them, the folks who don’t technically answer to your authority but must also somehow comply with your leadership. These worries and frustrations only fuel physician burnout and leadership disconnect, leaving us to wonder how to salvage the situation.

Physicians, regardless of their employment status, typically have naturally autonomous personalities. Further, all doctors want the support to do their job well, no matter whose emblem appears on their lab coat. So why does reaching independent physicians feel like an impossible task? It’s tempting to see independents as a group with distinctly different (though unclear) goals and beliefs than employed physicians. In reality, however, you can engage independent physicians with dedication to effective communication, accountability, onboarding, and rounding.

Dr. Independent

Modern Healthcare reports that in the past five years, the community of independent physicians has continued to shrink. In 2012, health systems employed only about a quarter of practices, while today that number has nearly doubled. Despite their presently shrinking numbers, the independent physician is not an endangered species and is in fact a very real and vital part of most healthcare systems.

Though tempting to set independent, in-network physicians aside and hope they sort their issues out on their own, we all know that the best way to understand anyone is by speaking with them. PRC’s physician engagement survey, for example, was uniquely designed with independent physicians in mind, allowing healthcare leaders to dig to the root of what worries those specific physicians hold. Once these myths begin to dissipate, the reality of the problems is often much easier to tackle than anticipated. Often, simple efforts in communication and relationship building can go a long way in making even the most isolated physician feel like part of the team.

4 Facets of Engaging Independent Physicians

Communication: Most hospitals struggle to create a cascading communication structure which facilitates physician involvement, finding that it’s difficult to create an efficient system when not all parties belong to the same organization. This often boils down to the fact that independent physicians don’t have the same email or intranet system as those employed, making it much more difficult to access all pertinent caregivers with one fell swoop.

Despite this, leaders must resist the temptation to treat their independent physicians differently than their employed. While it’s true that you’ll need to extend different communication efforts, ultimately all physicians want the same thing—healthcare partners who are both efficient and responsive to their needs. As they seek opportunity to provide input in decision-making and look to be informed, independent physicians need just as much communication as any other team member, if not more.

Accountability: Additionally, respect goes both ways and it’s important to hold each caregiver accountable for their work—however that may look. While you may feel more comfortable holding employed physicians accountable, you must set the same expectations for independents. Rather than holding employment over their head (a tactic which any leader should avoid) consider instead how to best build a partnership of accountability with your independent physicians.

Onboarding: Establish both communication and accountability measures early. During the onboarding process, set clear and specific expectations for how independent physicians should work with your network. These expectations must outline how your process benefits and supplements the independent physician, making it clear that to work with you is to simplify their process. Further, not only does establishing these procedures help your internal processes move more effectively, it also establishes that clear line of communication and helps physicians to understand how to best work with you and your resources. Remember that good onboarding strongly indicates retention and leverage this practice accordingly.

Rounding: Even the hospitals with the best senior leader rounding often neglect to round on their independents, typically because of barriers such as distance and communication which make planning the experience a hassle. Additionally, unlike other physicians, independents do not report up to anyone, naturally making it difficult to both facilitate and complete rounding. However, rounding on all physicians does nothing but good for leadership, physicians, and the entire organization. Not only does this present an opportunity for leaders to get to know the physician, but it also helps leaders to better understand the independent perspective and develop a trusting relationship.

Viewing your independent physicians as partners with the organization, rather than as unruly or distant can make all the difference in dispelling harmful myths and uniting your caregivers. Looking beyond physicians, creating a hospital culture which promotes trust and transparency builds or mends relationships of all kinds. Physicians by and large want to feel centrally involved in the organizations they work with, and by creating an environment which actively engages independent physicians, you’ve created an environment which feels both patient-centered and open to new ideas. Strategically managing independent physicians may be all it takes to dispel the myths and place your organization on a fast track for physician growth, alleviating physician burnout and leadership disconnect.