Understanding What Drives Physician Performance Will Lead to Better Care

By | January 9, 2019
Doctor Isolation

As physicians we are blessed to be members of a profession that allows us engagement with others in significant ways. We are fortunate to be invited by those we serve to aid them in their times of need. Furthermore, we are a purpose-driven profession with a mastery of skills. Above all, the autonomy of one’s practice is a crucial component of our joy and self-defined success. Unfortunately, this alone has not shown improvement in the quality of care received, nor contained the escalating costs of treatment.

Fortunately, addressing both our professionalism and drive to improve value is met with numerous solutions. Most current models utilize financial incentives to improve care. This mode premises that such economic motivations drive professionals and that they are the primary problem. However, I am not sure these are correct assumptions.

Undoubtedly, we all agree that our healthcare system is fragmented. Therefore, we have a system-based issue that is multi-factorial. I think it would be more affective to focus on how to leverage the motivation and purpose of physicians while simultaneously designing systems that elevate their skills and talents. Present pay for performance models just isn’t working, and physician satisfaction is waning. It is time for us to step back, evaluate, and refocus our efforts.

Khullar, et, al., in JAMA, recently addressed several of these issues. Key insights indicate the need for improvement within the context of physician motivation. In fact, the article shares enhanced engagement and activation is paramount for patient interactions and improved value. Our thinking must extend to what motivates and increases the joy of those delivering care. Numerous dynamics play into the human psyche, and we underestimate the value of social interactions, our desire for continuous learning, and our need for hope. Investigating different reward models is required for us to learn what works best. We all believe that improved culture is paramount to success, and yet, we don’t place enough emphasis on identifying what cultural dynamics lead to enhanced value.

If we focus on decreasing spending on healthcare, a competitive environment arises. Physicians are incredibly competitive by nature. How do we utilize this competitiveness to solve our system issues versus allowing internal fighting amongst different components of the healthcare ecosystem? Undoubtedly, combatting illness and improving wellness is our common purpose.

Therefore, placing a greater focus on co-solving our system issues is imperative. Team-based solutions must accompany team-based care. Working together and leveraging our strengths will aid us in overcoming our weaknesses. Without a doubt, our greatest strength is our humanness and what is accomplishable when we join for a common purpose.

Let us refocus our energy and financial resources in a manner that addresses these various core dynamics rather than only trying different payment models. Continued success will require innovative approaches, adapting human behavior models, a return to professionalism, and the knowledge that a shared journey with a common purpose will not only enhance the value we deliver as well as elevate the joy of serving.