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SPANNING THREE DECADES OF VALUE MANAGEMENT LEADERSHIP

October 16, 2001

HOW TO GAIN PHYSICIAN BUY-IN TO YOUR PROPOSALS AND RECOMMENDATIONS

In my travels throughout the USA, I frequently ask the question of healthcare executives, “ what is the biggest challenge that you are facing related to cost management?” the answer is always gaining physician buy-in to my proposals and recommendations.  While I agree this is a challenge for all CEOs, COOs, CFOs, and MMs, we must also realize that the normal response to any proposed change that you would make is RESISTANCE TO CHANGE!  This statement is a shock to most healthcare executives who believe that they have such a good idea to save money, why would any reasonable physician oppose it?

This is the misconception that most healthcare executives have when they propose even a minor change in products, services, technology or practices to physicians:  That every-one involved in the decision to change will just fall in love with their idea.  In reality, their expectation should be that they are going to have much resistance to their proposed change.  Once this fact is understood and accepted, you then can realistically prepare and plan for it.

“The key to understanding the human reaction to change is to understand how important familiarity and control are to…(physicians) is an astute observation on human nature from the Total Quality Newsletter.  This quote opens the window to understanding why physicians won’t approve our savings proposals and recommendations without first resisting our ideas.  It enlightens us that all physicians are thoroughly satisfied with the products, services and technology they are now using.  They are knowledgeable in how they work and familiar with any drawbacks or limitations of the product, service or technology they are buying.  This familiarity gives them great comfort.  Any change, even a small one, could give them pain, which they want to avoid at all costs.

However, no change is impossible as the great teacher and researcher on the subject, George S. Odiorne believed, “most people like those changes they cause to happen, for they are adapting as they create the changes….” He further recognized that, “When people participate in making decisions, they make their expert contribution.  Thus they often are able to prevent the kinds of errors, which grow out of ignorance.  They also acquire more enthusiasm for the decision, or at least have some of their serious reservations removed, and accordingly work more diligently to make the decision work in practice.”  Based on these tenets, if we want our physicians to change their products, services, technologies or practices then we must:

1.                  Have Them Participate In The Change

        One of the basic laws of change management is that all parties who are to be affected by the change must participate in the change, thereby giving your physicians familiarity with the change and some control over it. 

2.                  Have Them Expect The Change

        We can accept even a major change if we expect it and are prepared for it. This is a vital ingredient for successful change management.  But if a change is unexpected and inconsistent with our perception, even small changes can turn into WARS.

3.                  Have Them Believe the Change is Necessary

        “Sustained, positive change happens when affected (physicians) can be convinced the price from maintaining the status quo is significantly higher than the cost of transition,” says the Total Quality Newsletter.  Therefore, to introduce a change in a product, service, technology or a practice you must convince your physicians that the change is necessary, since change will happen only if your physicians can be convinced that the change is necessary for their or your organization’s survival.