Physicians can often feel like administrators think of them as production-line workers and that administrators don’t understand the challenges doctors encounter taking care of patients.
On the flip side, it’s not uncommon for administrators to believe that physicians don’t understand the challenges those in the C-suite face in running a hospital or health system, including the financial pieces required to ensure long-term viability.
This disconnect inflames a number of situations that studies show are key drivers of physician burnout—a lack of autonomy, perceived unfairness, a breakdown of community and an “us-versus-them” mentality.
Building trust is key to resolving that physician-administrator tension and helping reduce burnout drivers. An AMA playbook helps health care leaders discover ways that they can build a culture of trust and eliminate the physician-administrator gulf that contributes to physician burnout.
“A trusting environment is one of the most valuable characteristics of high-functioning organizations. In health care organizations, trust between physicians and administrative leaders, physicians and peer (work unit) leaders, and physicians and patients are all vital for organizational well-being as well as excellent patient care,” says the “AMA STEPS Forward® Wellness-Centered Leadership Playbook” (PDF).
In addition to building a culture of trust, the playbook explains the importance of feedback and how leaders can give and receive feedback, prioritize well-being and make unit level changes effectively.
5 ways to build trust
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How health care leaders behave can influence an organization’s culture. This is because leaders are the ones responsible for generating trust in their organizations, including internally among physicians, health professionals and other employees.
The playbook outlines five ways leaders can go about building trust between physicians and administrators in a health system or hospital:
- Create clear and transparent communication channels such as town halls, informal social events, administrator-physician dyads or triads and “listening campaigns” that include one or more listening sessions between a facilitator or physician leader and a group of practicing physicians.
- Offer opportunities for physicians and administrators to learn more about one another’s roles. For example, administrators can shadow physicians in clinics and attend team huddles or team meetings.
- Develop shared core values and a willingness to work toward a common core mission and vision. For example, this can be written out via organizational compacts.
- Hold town halls and informal forums or social events where physicians can share their personal stories because “the power of personal narrative cannot be ignored when building trust.”
- Set up a “trust challenge” where groups within an organization share their best practices for building trust within their team, with other teams and with patients.
An AMA STEPS Forward toolkit, “Building Bridges Between Practicing Physicians and Administrators,” contains more in-depth information to help organizations recognize the drivers of physician-administrator distrust, explore methods to strengthen trust and outline strategies to improve these relationships.
Starting the conversation
The “Wellness-Centered Leadership Playbook” also offers four questions to guide administrators as they start conversations aimed at building trust:
- How did a recent event or change impact your life?
- What does value and appreciation at work feel like for you?
- What prevents you from doing a job that makes you proud?
- What can be done to move forward and help you do a job that makes you proud?
Don’t forget about communication
Beyond establishing ways for dialogue to take place between practicing physicians and administrators, it’s important for leaders to create an organizational level strategy to communicate with practicing physicians and others in a way that works for those receiving the communication, the playbook says.
Among the components of a communication strategy that promotes well-being are:
- Identifying existing communications and marketing resources to reveal any gaps in how the organization disseminates information about well-being.
- Determining whether those receiving the communication are aware of confidential, non-punitive mental health and well-being support resources that are available and investigate any gaps.
- Finding out what information people need most.
- Delivering messages in a tone that resonates as caring.
AMA STEPS Forward open-access toolkits and playbooks offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
