Speak Out Without Getting Into Trouble

Leigh Page

Disclosures

February 14, 2018

In This Article

Speak Your Mind Without Being a 'Troublemaker'

More and more physicians work in large groups, hospitals, or healthcare organizations. And in these organizations, they often come up against policies they dislike—policies that might force unwanted changes that they don't agree with and want repealed.

The challenge for physicians then becomes: How do you express dissatisfaction without being labeled disruptive or difficult? And how do you effectively convey your concerns in a way that can get results?

Dealing with this situation can put physicians in a quandary. They don't want to put their jobs at risk by speaking out. But if they keep silent, it can be more difficult for them to uphold patient care, perform clinical duties, and ensure that needed equipment and personnel are in place.

Disagreeing with management is not a rare situation. A 2016 Medscape survey of employed physicians showed that 57% disagreed with their employer on workplace policies, 42% disagreed on patient care, and 28% said they had less control over work and schedules.[1,2]

To resolve these problems, physicians must have a way to communicate their needs to management. But their attempts are often unsuccessful, says Greg Mertz, a practice management consultant based in Virginia Beach, Virginia, who works with physicians in large organizations.

Don't Hesitate to Speak Up

First, management often simply bats down many requests. "In many cases, administration automatically assumes that whatever doctors are asking for is self-serving and not in line with the needs of the organization," he says. "Administration thinks, 'It's just those whiny doctors who are tone-deaf.' So the first response is just to say 'no.'"

This leads to a great deal of frustration for many physicians. Only 34% of hospital-employed physicians were satisfied with the level of communication in their organization, according to a 2016 survey by Jackson Healthcare, a physician recruitment firm.[3]

But there are ways to get your ideas across, and perhaps influence the decision or policy.

The first thing physicians need to do is speak up, Mertz says. "Many doctors never want to bring their ideas and concerns to the forefront," he says. "They're always waiting for somebody else to speak up. That can leave them very frustrated and cynical. They may say, 'No one ever listens to me, so why try?'"

Physicians need to press an issue before they are heard, Mertz says. "Management can be more reactive than proactive," he explains. "If the organizational pain level is tolerable, management will be hesitant about trying something new."

For example, if a physician proposes a project that would require "spending money to make money," such as hiring more personnel or buying a new piece of equipment, "management can get very cautious, even when success seems obvious," Mertz says.

In another example, physicians are assessed on a long list of metrics, some of which may be useless or even counterproductive, according to Mark H. Belfer, DO, a family physician who is chief medical officer at the Greater Rochester Independent Practice Association in Rochester, New York.

Physicians may feel that the counterproductive metrics are set in stone, but "if you speak up and explain yourself, it may be possible to have the metric removed," Dr Belfer says.

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