New Study of Healthcare Organizational Culture Reveals Substantial Gaps Between Physician Satisfaction and Organizational Performance
Posted November 13, 2012
hysician Wellness Services and Cejka Search study helps to show impact of organizational culture on physician engagement, recruitment and retention
A new Physician Wellness Services and Cejka Search study found substantial gaps between physicians’ satisfaction and experience with key cultural attributes in their healthcare organizations. The study explored the influence of 14 cultural attributes on physicians’ overall satisfaction, and their perceptions about their organization’s performance related to those cultural attributes.
A companion study of hospital administrators found that while they have a reasonably good sense of what is important to physicians’ satisfaction in terms of organizational culture, administrators consistently feel their organizations perform better with regard to cultural attributes than physicians think the organizations perform.
“The study clearly shows areas of disconnect between what physicians look for and what they find – and what organizations think they provide,” said Dan Whitlock, M.D., Physician Wellness Services consulting physician. “In our work with physicians and healthcare organizations, we find that this often leads to dissatisfaction, frustration and cynicism, sometimes with behavioral impacts. At a time when physician engagement is of paramount importance and healthcare organizations seek to promote satisfaction and loyalty, closing these organizational culture gaps can have a strong positive impact.
“Cultural fit is a determining factor in a physician’s decision to join – or leave – a practice,” said David Cornett, Senior Executive Vice President of Cejka Search. “Because turnover and prolonged physician vacancy can cost a practice as much as $100,000 per month, organizations can achieve significant returns by investing in the assessment and cultivation of cultural fit.”
“I just switched organizations for all the reasons your survey is focusing on,” said a physician respondent. “Thanks for helping me see the words and themes which prompted me to seek out a new job and my subsequent satisfaction with my new organization.”
High/Low Ranking Attributes and Gap Areas
A patient-centered care focus is by far the most important cultural attribute to physicians, the study found. This attribute also had one of the smallest gaps between physicians’ expectations and how well they believe their organizations address the attribute, indicating greater congruence on this important core attribute.
The highest-ranked cultural attributes for physicians are respectful communication, a team-focused environment, and supportive management regarding errors and mistakes. However, their satisfaction scores indicate that all of the attributes surveyed were important to them. Physicians’ average scores regarding the importance of all but one attribute fell into the uppermost quartile of the 10-point Likert scoring scale.
Transparent communication, collaborative leadership style, and organizational adaption to change are attributes with the biggest gaps between what physicians consider to be important and what they perceive their organizations to be delivering.
The gap between importance and organizations’ delivery is smaller on cultural attributes such as clear mission and values, and objective performance evaluations. But notably, these are attributes that physicians rank as having lower influence on their job satisfaction.
Ultimately, the largest gap – and the one that is most relevant to physicians in the long-term – is that between their satisfaction with their organization’s focus on an attribute and the ideal – a perfect 10 on a 10-point Likert scale. From that perspective, the gaps, ranging from 3.0 to 4.3 points, are considerable.
Influence of Cultural Fit on Recruitment and Retention
The study also found that administrators underrate the influence of organizational culture on physicians’ decisions to accept or leave jobs. Most physician respondents agreed that expectations of cultural fit are a determining factor on whether or not to accept a practice opportunity, and at least half agreed that lack of cultural fit prompted them to leave. Administrators felt cultural fit was a factor for physicians accepting or leaving a job about one-third of the time.
“Physician respondents said that cultural fit has prompted them to leave or decline a position to a higher degree than administrators estimated was the case,” Cornett noted. “This reveals a gap that organizations can fill by more objectively assessing cultural fit and engaging physicians in on-boarding and team-oriented activities that support a strong cultural fit. This is especially critical in the first three years of joining a practice, when recruits are highly vulnerable to turnover.”
Mind the Gap: An Rx for Some Cultural Health Improvements
“Administrators’ mistaken belief that their organizations are demonstrating competence when their physicians feel differently can lead to decreased efforts to create cultural congruence,” said Robert Stark, M.D., Physician Wellness Services consulting physician. “As more physicians become employed, consolidation continues, and work toward healthcare reform proceeds, physician engagement has become increasingly urgent while healthcare organizations work to develop models and systems to improve care and reduce costs.”
Dr. Whitlock stated there is tremendous opportunity for healthcare organizations to understand how they can fully engage physicians – whether they are employed or independent – and create better retention and recruitment programs. Physician Wellness Services and Cejka Search both have practices and programs that can assist organizations in closing the organizational culture gaps.
Several respondents indicated they were happy with their organizations and one respondent’s comment indicates the potential benefits of a healthy culture: “My organization’s cultural attributes are what has encouraged me to put off my retirement. It is a pleasure for me to work here.”
Organizations also should be mindful of cultural shifts over time due to staff and leadership changes, as well as organizational and industry evolution, Dr. Stark added. As one physician respondent noted, “I joined my practice because of good cultural fit. The entire structure of the group has changed since joining six years ago. I’m completely unsatisfied with new structure.
About the Survey
The physician and administrator surveys were conducted in October 2012 using a confidential online survey instrument, and collected responses from more than 2,200 physicians nationwide representing multiple specialties, and 123 administrators. Physician respondents closely reflected a demographic representation of the national physician population.
Based upon a review of the research on organizational culture attributes in healthcare organizations, 14 cultural attributes were identified that were particularly relevant to physicians. Respondents were asked to rate each of them based upon the importance of that attribute to their overall satisfaction; the degree to which they agreed their organization demonstrated that attribute; and their satisfaction with their organization’s focus with regard to that attribute.
The administrator survey mirrored the physician survey, asking administrators to assess how physicians would rate the 14 cultural attributes and their perceptions of their organization’s performance against those attributes.
For more information on the study, please visithttp://www.physicianwellnessservices.com/news/orgculturesurvey.php
About Physician Wellness Services
With providers in every major city and wide-ranging expertise in every aspect of behavioral health, Physician Wellness Services is the only company today that gives doctors and healthcare organizations easy access to the help they need, whenever, however and wherever they prefer.
Their comprehensive, end-to-end solution includes: The Physician EAP, Physician Intervention Services, andTraining & Consulting
For more information visit: www.physicianwellnessservices.com
About Cejka Search
Cejka Search, http://www.cejkasearch.com, is a nationally recognized physician and allied health and healthcare executive search firm providing services exclusively to the healthcare industry for more than 30 years. Cejka Search recruits top healthcare talent for organizations nationwide through our team of experienced professionals, award-winning recruitment technology and commitment to service excellence. Cejka Search is a Cross Country Healthcare, Inc. (Nasdaq: CCRN) company, a leading provider of healthcare staffing services in the United States.