Feedback. It’s key to fostering the trusting environment that is recognized as one of the most valuable characteristics of a high-functioning organization.
Leaders need to give feedback to the physicians they lead.
Equally important, leaders need to get feedback from the physicians they lead.
An AMA playbook helps health care leaders discover ways they can give and get productive feedback and build a culture of trust to help eliminate the physician-administrator gulf that contributes to physician burnout.
“Feedback can take the form of real-time teachable moments or ongoing weekly, monthly or quarterly dialogue that includes appreciation, feedback and support,” according to the “AMA STEPS Forward® Wellness-Centered Leadership Playbook.”
The playbook offers three forms of feedback an organization can establish and strategies that leaders can use to gather and deliver feedback.
Informal dialogue
Feedback doesn’t always have to be as formal as a sit-down review or a questionnaire to gather information on physicians’ thoughts.
Instead, feedback can be given during informal dialogues that take place in staff meetings, daily huddles, other team meetings, or in other settings. The AMA STEPS Forward toolkit on appreciative inquiry principles describes an approach that uses “unconditional positive” questions to identify what is working well. For example:
- What is something we can celebrate?
- What made the team successful?
- Have you noticed a colleague go beyond the call of duty recently? How so?
These interactions can help “build on the positive and create a shared vision going forward,” the toolkit says. Constructive feedback can also be given in the moment, though it’s not always the right time. Leaders should first ask physicians whether they are open to hearing the feedback and let them know it can be deferred to another time if they are not open to it in the moment.
Physician annual reviews
Annual physician reviews can be a time for leaders to nurture the partnership between physicians and leaders. To build trust and promote professional development, leaders can structure the annual review conversation around these five elements.
- Include: A leader’s body language, words and actions should make a physician feel comfortable and included.
- Inform: All the information that is appropriate for the one-on-one encounter should be communicated transparently.
- Inquire: Ask the physician what brings them joy. Leaders too often make incorrect assumptions. The ensuing discussion can help inform a discussion on how to develop and nurture a person’s interest. This, in turn, can reduce the chance of burnout.
- Develop: Discuss career goals and create a plan to help the team member accomplish them.
- Recognize: Express gratitude for things the person has done individually or as part of a team.
Physician feedback to leaders
To grow and to promote a culture that is less prone to burnout, leaders need feedback from the physicians they lead. This ideally should happen once a year.
Physicians should be able to provide direct feedback about the leader’s behaviors and the impact those behaviors have on them personally, focusing on the leader’s actions and interactions with team members.
The AMA’s practice transformation team has a set of leadership assessment questions as part of their “Organizational Biopsy®,” an organizational well-being assessment. Physicians are asked how strongly they agree or disagree with a statement, including:
- My contributions are recognized by my immediate supervisor.
- My immediate supervisor solicits and follows up on my ideas and perspectives improving workflows, teamwork, policies or practices.
- My immediate supervisor shares organizational information openly with me regarding finances, quality metrics, reasons behind decisions, and more.
AMA STEPS Forward open-access resources 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.
