Are Your Colleagues Competing With You?

Shelly Reese

Disclosures

February 27, 2013

In This Article

Introduction

It used to be that doctors competed for patients and for the financial rewards that followed: bigger offices, fancier cars, professional prestige.

That was then.

Today, as the move toward hospital employment continues, fewer physicians are going head-to-head for patients. What's more, their motivations have changed. Younger physicians are more concerned with quality-of-life issues and work/home balance than their predecessors were.

But although steady paychecks and shifting priorities may have diminished the importance of attracting the maximum number of patients, they haven't eradicated the competitive instinct. Even though they may work for the same employer, physicians still compete on myriad levels: for resources, call schedules, awards, and committee chairs.

"Physicians as a whole tend to be somewhat competitive by nature," says David Cornett, senior executive vice president of business development for Cejka Search, a St. Louis, Missouri-based physician recruiting firm. The profession "self-selects somewhat for people who are very smart, analytical, and competitive."

Whether that competitive drive is good, bad, or indifferent depends a lot on how -- and with whom -- doctors are competing.

Competition Is Intrinsic for Many Physicians

You didn't get into medical school or land a prestigious residency because of your good looks and charm. You studied, worked hard, and outperformed your peers who were seeking the same goals.

Chances are, if you entered the workforce more than a handful of years ago, you joined a private practice and that hard-nosed determination served you well, enabling you to build your practice and compete successfully in a fee-for-service world. What worked in an autonomous practice setting, however, may not suit a broader organizational culture.

Consequently, the healthcare system is caught in an awkward cultural transition: Although physicians extol the value of teamwork, organizations haven't achieved it. Asked to rate the importance of working in a team-focused environment on a scale of 1 to 10, with 10 being "extremely important," three quarters (74.2%) of the nearly 2300 physicians surveyed by Cejka in October 2012 gave it a rating of 8 or higher. Asked whether they were satisfied with their organization's team orientation, however, fewer than one half (40.5%) gave their institution high marks. More than one quarter (26.4%) expressed dissatisfaction -- a rating below 3 on a 10-point scale -- with the collaborative leadership style demonstrated by their organization.

To a degree, competition -- particularly among physicians in certain specialties -- is inherent, insists Tommy Bohannon, a divisional vice president with Merritt Hawkins, an Irving, Texas-based physician recruiting firm. "You'll always have turf battles between specialties," he says, citing such examples as cardiologists and radiologists; radiologists and vascular surgeons; and neurosurgeons and orthopedists competing for spine cases.

What's more, competition can be a powerful motivator. Competition with an outside organization can promote team building and spur a group's performance, notes Columbus, Ohio-based business psychologist Roger Hall, PhD. Bohannon notes that self-directed competition motivates individuals to achieve their full potential.

"For a lot of people being competitive is really about setting goals for themselves and self-betterment," Bohannon says. "They simply want to rise to the top of their field."

David Cornett argues that pride and a sense of competition can drive underperforming physicians within a group to improve. "Because they're analytical and competitive, if you give good data to good physicians they'll produce good results," he says. "In almost every case I've seen, when you start giving physicians real data about their practice and outcomes, you will see outliers move toward the middle of the pack, and they do it because they're competitive."

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