When it comes to communicating diplomatically with physicians about compliance issues, it can be a little—oh what’s the word? Tricky?
Over the years I’ve come to realize that it is important to keep a few thoughts in mind about physicians when they are your audience. First, physicians tend to be competitive by nature. Their educational experience consisted of striving to be the top of their class in order to enhance their career path.
Also, physicians, unlike healthcare leaders, were trained to be autonomous decision makers. As a consequence, physicians have an internal expectation to be efficient with their decisions. The autonomous decision-making trait of physicians is much different than the groupthink model of healthcare leaders.
Finally, physicians are specifically trained to be precise. As a result, they tend to expect the same from those they work with (whether it’s clinical or administrative staff).
Since physicians are trained to make their own decisions, they tend to not like to be told what to do. Unfortunately for you as the compliance officer, they will see your communications with them as doing just that. Additionally, some physicians tend to feel “the rules” are a nuisance, getting in the way of providing patient care.
So how can you shift a physician’s mind-set from “You can’t make me do that” to one that is engaged in compliance?
Below are some communication strategies that will help.
Define Your Message Going In
When you’re communicating with physicians about a compliance matter, before meeting with the physician, define your message going in. More specifically, what are your concerns, and what is your rationale for those concerns? For example, assume you have identified a lack of documentation in the medical record to substantiate the billing of a particular service. In that case, you need to be able to articulate the specific concern, have documentation of the billing requirement at issue, and outline other regulations or authority that impacts billing for the service (Medicare billing guidelines, False Claims Act, etc.).
As part of defining your message, you also need to make sure you have identified any action items you are expecting from the physician. Continuing with the above example, outline what documentation must be present in the medical record going forward.
One final thought to add here is that if you’re working through a complex matter, you may want to consider running the discussion past a physician leader first (such as the CMO or medical director). Since other physicians are the constituency for physician leaders, their interests will be aligned with yours to ensure that the discussion goes smoothly with the physician. For that reason, they can provide helpful and constructive feedback to help shape the eventual discussion with the physician.
“So What Do You Need from Me?”
If there is one single piece of advice I could give you related to physician communications, it is this: before you have a conversation with any physician, make sure you can answer in your head this question: “So what do you need from me?” Taking this approach is consistent with my earlier comment about making sure you have identified specific action items needed from the physician.
Early in my career, I learned this lesson a few times...the hard way. After communicating with physicians on various topics without putting thought into how the discussion might unfold, I consistently ran into this response. I got too focused on what I wanted to say in explaining a concern that I failed to be prepared for a basic question from the audience’s viewpoint.
Being prepared with a response to that question will help you in your communication with the physician for a couple of reasons. First, it demonstrates being efficient with the physician’s time, which they will appreciate. Second, by seeing the topic from the audience’s viewpoint, it will enhance their trust in you that you understand their POV. In my experience, taking this approach has helped me in gaining buy-in from physicians to the compliance program.
Leverage Physician Champions
Another way to diplomatically communicate with physicians is to leverage support from any available physician champions, such as the CMO or medical director. If you work in a hospital setting, there will be a medical staff office with a range of physician champions who may be available. These particular physician administrative roles are designed to address both clinical and administrative concerns involving physicians. As I mentioned earlier, anytime you can have physician-to-physician discussion related to a compliance matter, your chances of buy-in will significantly improve. Physician champions can help communicate your objectives into terms a physician can relate to, and the physician can feel heard if he or she is in disagreement. Generally speaking, CMOs and medical directors will have “ensuring compliance with all federal, state, and local laws and regulations” as a requirement in their contract. To that end, your interests will be aligned.
Pulling it All Together
Due to the nature of our role in the organization, we are in a position to influence the behavior of others on a daily basis—that includes physicians. In order to positively influence their behavior, you need to communicate your compliance message in a way that results in gaining their buy-in. By focusing on the above strategies, you will significantly increase your chances of obtaining their buy-in, and be in a far better position for navigating the politics of healthcare.
_____________________________________________________________________________
