Table of Contents
Foreword Imran A. Andrabi, MD, FAAFP xv
Preface xix
Acknowledgments xxvii
Introduction Carson F. Dye 1
Strong Physician Engagement Is No Longer a Luxury 3
As Healthcare Organizations Grow Larger, Consolidation Is Inevitable 3
Physicians Are Already Highly Engaged Individuals 4
Physician Engagement Is Complicated 4
Engagement Is Not Synonymous with Alignment 5
There Still Exists a Physician Mystique 5
Physician Leadership Is a Key Component of Engagement 6
Physicians Are Not All Cut Out of the Same Cloth 6
Strong Physician Engagement Is Possible 6
Tolerating a Conclusion Is Not the Same as Embracing It 7
Overview of Chapters 8
1 Employee Engagement: Precursor to Physician Engagement Carson F. Dye 13
Ambiguity About the Concept of Employee Engagement 14
The Literature on Employee Engagement 15
Three Parts of Employee Engagement 18
The Emerging Science of Engagement Through Visualization and Storytelling 19
Engagement: More than Happiness or Satisfaction 20
Conclusion 20
2 Literature on Physician Engagement Carson F. Dye 27
Overviews in the Literature 28
Traditional Views of Physician Engagement 28
The Many Views of Physician Engagement 30
Conclusion 39
3 Physician Engagement Models Carson F. Dye 45
A Two-Factor Model 45
An Eight-Factor Model 51
Conclusion 53
Chapter Appendix 61
4 Aiming to Better Understand Physicians Douglas A. Spotts 65
A Unique Learning Style 65
A Never-Fail Attitude 67
Cooperativeness and Creativity 67
A Tendency to Question Everything 69
Change Management 70
From Engagement to Leadership: How Physicians Can Develop into Engaged Leaders 74
Advantages of Having Physicians at the Table 77
Beyond Engagement to Alignment: Case Study 78
Physician Leaders in Stressful Times 80
Potential for Burnout 81
Physicians Develop "Range" 83
Conclusion 83
5 Larger Paddles and Bigger Boats Lisa M. Casey 87
The Evolving Qualities of Excellent Physicians 89
Consequences of Disenfranchised Physicians 92
The Boat as a Metaphor 93
Concrete Ideas to Emphasize the "What, the Why, and Trust 102
Conclusion 104
6 Physicians as Leaders Carson F. Dye 107
Can We Say All Physicians Are Leaders? 107
Does Clinical Practice Have Similarities to Leadership? 108
How Do Physicians Become Leaders? 110
Physician Leaders Have a Significant Influence on Engagement 115
Do More than Simply Ask Physicians for Their Input 116
Provide for Camaraderie and Community in the Work 118
Leadership Can Help with Burnout 120
Are Physicians Different? 120
Chief Medical Officers Cannot Do It All 122
Conclusion 123
7 Visual and Participative Concepts That Apply to Physician Engagement Kalen Stanton 127
Visualization 128
Getting Physicians in the Game 135
Bringing It All Together 137
It's Worth It 139
Join the Visual Movement 140
Value in Real Time 141
Conclusion 142
8 How Physicians Feel Engagement; How Leaders Enhance It Harjot Singh 145
Engagement at an Individual Level 148
Three Personal Benefits of Flow 154
Common Missteps in Efforts to Enhance Physician Engagement 156
Key Questions to Ensure That Engagement Happens 161
Organizations Without Physician Engagement Programs 162
Conclusion 163
9 The Economic Model: Does Money Generate Engagement? Carson F. Dye 167
Factors Affecting Motivation 170
Insights from Physician Leaders 173
Conclusion 180
10 Mining for Conflict, Jeremy Blanchard 185
Conflict over Delivery of Care 186
Conflict of Professionalism 186
Conflicts of Leading with Power 188
Conflict of the Story That Never Happened 189
Healthcare, the Perfect Milieu for Breeding Conflict 190
How Does Conflict Mining Accelerate Your Leadership Success? 191
How to Mine for Conflict 192
Concrete Tactics for Facing Conflict 193
Pitfalls to Avoid in Conflict 198
Using a Dashboard to Improve the Value of Conflict 199
Exercises to Develop Key Skills 200
Conclusion 202
11 Gender Issues Kathleen L. Forbes 205
Let's Review the Data
Career Decision Challenges During Training 208
Challenges with Selecting a Professional Practice 210
Implicit Gender Bias 211
Developing Female Physicians' Leadership and Engagement 212
Ten Suggestions for Healthcare Organizations to Engage Female Physicians 214
Conclusion 218
12 Cognitive Diversity Raúl Zambrano 223
The Challenge 224
Providers as UREMs 225
The Patients The Providers 227
Management of Physicians 228
Trust 228
Communication 230
Meetings 231
Burnout 234
Conclusion 237
13 Physician Flourishing: Moving Past Burnout Katherine A. Meese Andrew N. Carman 243
What Does Flourishing Mean? 244
Positive Emotion 245
Engagement 245
Relationships 246
Meaning 246
Accomplishment 247
Individual-Level Interventions 248
Team-Level Interventions 252
Organization-Level Interventions 256
Policy-Level Considerations 257
Conclusion 259
14 Getting to "Us" from "We Versus They," Robert Dean 263
Why Financial Incentives Are Not Enough 264
Physicians as Beneficiaries 265
What Creates Engagement? 267
Considerations for an Organizational Engagement Structure 271
Conclusion 280
Conclusion: Summing Up the Experts' Knowledge Carson F. Dye 283
Understanding Physicians 284
Giving Physicians a Bigger Role 284
Recognizing Physicians as Leaders 284
Ensuring a Line of Sight and Participation 285
Understanding How Physicians Feel Engagement 285
Considering Compensation 286
Managing Conflict 286
Paying Strict Attention to Diversity and Gender Matters 286
Helping Physicians Find Their Flow and Flourish 287
Ending Administrative-Physician Competition 287
Index 289
About the Editor 309
About the Contributors 311