I initially wrote on this topic in 2014 for the Health Care Blog about early experiences at creating the right professional culture within a primary care group. My insight at the time was really simple; lets implement some of the best practices that I had learned as a partner at McKinsey & Company for managing and developing management consultants and apply them to primary care physicians. It worked brilliantly and proved to be a far more effective scalable lever than using operations or technology, contrary to conventional wisdom.
Since then I have given a number of talks on this model and had great discussions with innovators in international health systems — Australia, Mexico, Netherlands, Sweden and the UK about how to apply effectively to the entire clinical team.
Foster understanding and conviction. “I know what is expected of me – I agree with it, and it is meaningful.” Clinician mindsets are the critical foundation. Foundational criteria that we use at Rezilir Health that are critical to recruiting effective clinicians include a strong:
Ability to develop relationships with patient, care team members
Locus of control manifested by a willingness to be accountable for one’s own actions
Mission, specifically a burning desire to improve patient care and a belief that there is an extraordinary opportunity to improve medicine today
Role-modeling. “I see superiors, peers and subordinates behaving in the correct way.” At Rezilir Health we practice collaborative interdisciplinary care in our entire model. This can happen in the first:
Visit when a patient signs up for a full interdisciplinary evaluation
Month when a case is reviewed in an interdisciplinary team meeting
Year as there is ongoing collaboration between the team
To get collaborative care right it is critical for clinicians to see ideal behaviors and to see colleagues practicing the right way. It is better to spend more time initially on a few cases and get the model right.
Developing talent and skills. “I have the skills and competencies to behave in the correct way.” Given the unique model we are developing, we take it as a given that everyone will be climbing a steep professional learning curve. The critical factor is to get a core of high quality individuals and to work with partners in developing skills as well as content. While content is easier to measure, developing skills is the much harder and rewarding approach. We are keen on going into the exam room and working through the improving the doctor-patient relationship using video tools and home visits.
Reinforcing best practices with formal mechanisms. “The structures, processes and systems reinforce the change in behavior I am being asked to make” The key mindset here is to create a path of ongoing professional development where clinicians know that the organization is committed to their overall development. We don’t believe that incentives will motivate the right behavior; however, we need to remove incentives that motivate the wrong behavior. As a result, we spend more time around transparency with all metrics than designing complex compensation schemes.