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What Good Doctors Want

10 Ways Accountable Care Organizations Can Win the Hearts and Minds of the Best Doctors and Physician Practices

Mike Killeen teaches healthcare marketing at Emory University’s Rollins School of Public Health. He is Vice President of Marketing at LENZ, an integrated marketing company that specializes in marketing physician practices, hospitals, and ACOs.

As anyone working in American medicine knows, the Patient Protection and Affordable Care Act of 2010 initiated a tectonic shift in how healthcare is delivered. Healthcare providers are moving away from the old fee-for-service model that rewards providers for ordering lots of expensive tests, office visits, and procedures. And they’re moving toward an outcome-based model, in which compensation is tied to the health of individual patients and to the overall served population, as well as to cost savings.

Think of it as the “quality over quantity” model of healthcare, with accountable care organizations (ACOs) as its most visible manifestation.

ACOs need doctors. OK, that’s obvious, so let’s revise: ACOs need good doctors. Ideally, they want to either acquire or partner with the very best doctors and physician practices. But what if the good doctors aren’t interested?

The thing is, good doctors and physician practices may be doing just fine (for now) on their own and may not be interested in joining ACOs. And, at least in larger markets, those who are interested may have more than one suitor.

The best doctors are already delivering quality care, and doing so reasonably efficiently. They run their businesses relatively well. They have established referral networks that keep them booked. They help their patients, inspiring loyalty and recommendations. They make good money. So what’s their incentive to change?

To attract the best doctors and physician practices, ACOs have to appeal to what the good doctors most want, then demonstrate to them how ACOs can help.

So what do the good doctors want?

1. Good doctors want their patients to get well-coordinated care.

The human body is extraordinarily complex. Good doctors have confidence in what they know well and the humility to reach out when someone else will know better. They want to collaborate with other doctors and healthcare professionals to provide the best comprehensive care for their patients. Given the opportunity, they’re usually quite good at it.

Show doctors how your ACO will make it easier for them to collaborate with their peers, working together for the best possible patient outcomes.

2. Good doctors want to develop and maintain long-term relationships with their patients.

It’s not about making friends. Good doctors believe in the sanctity of the doctor-patient relationship. They know they can deliver better care when they learn, over time, the characters and qualities of their patients that even the most comprehensive electronic health records system could never capture.

Show good doctors how your ACO will strengthen, not replace, the doctor-patient bond, such as with patient portals that make it easier for patients and their doctors to communicate outside the exam room.

3. Good doctors want their patients to practice the basics.

Eat right, don’t smoke, exercise regularly, and get enough sleep. Good doctors know that those four practices will keep their patients healthier than any pill ever could.

Show good doctors how your ACO’s coordinated care will encourage healthy habits with coaching, classes, smoking cessation programs, and other initiatives to encourage healthy behaviors.

4. Good doctors want better technology to serve more personalized care.

Data-based medicine should inform a good doctor’s judgment, not replace it. Good doctors want high tech paired with high touch, empowering their decisions, not hobbling their independence.

Show good doctors how integrated health IT within an ACO will give them a more complete picture of a patient’s health and ongoing treatment, informing their judgement as they plan the best care.

5. Good doctors want to focus on medicine, not bureaucratic burdens.

This doesn’t mean good doctors dislike the running of a business. Some of them enjoy it very much and will appreciate — even insist on — opportunities to exercise their entrepreneurial spirit. But good doctors will gladly turn over to an ACO the handling of insurance, transcription, record-keeping, billing, and other administrative necessities.

Show doctors you’ll help them get back to being doctors.

6. Good doctors want to be leaders.

If you bring good doctors into your ACO and don’t ask them to take on leadership roles, you’re wasting a valuable resource and likely frustrating your good doctors. Successful ACOs rely heavily on physician leadership.[1][2]

Show doctors you value and want their leadership, and give them real leadership in your ACO.

7. Good doctors want to be respected by their peers.

Good doctors have studied and worked hard to become good doctors. They’ve earned the respect of their peers, and they don’t want to give that up to become anonymous employees of your ACO. A good doctor is not a commodity, not an interchangeable cog in the healthcare machine. Each brings individual expertise and accomplishments that are worthy of recognition and respect.

Show good doctors that you value them and will promote them as individuals, worthy of their peers’ respect.

8. Good doctors want to have a good reputation in their community.

Good doctors and physician practices work for years to build their reputation in the community, and that reputation is worth a lot. It’s part of why you want them to join your ACO. They don’t want to lose that reputation by disappearing into an anonymous division of a large corporate structure.

Show them you won’t just market your ACO’s brand. Show them you see the value of marketing your doctors and physician practices, enhancing your own brand by showcasing the expertise of your good doctors.

9. Good doctors want to deliver great care to more people.

Fundamentally, good doctors want to help people. They want to deliver high quality care to each individual patient, and, to the extent they can do so while maintaining that quality, they want to help more people. This balance is completely in line with the goals of outcome-based healthcare and the ACO model: delivering higher quality care to each individual and to the population, while controlling costs by finding greater efficiencies.

Show good doctors how your goals are in alignment.

10. Helping the good doctors do more.

ACOs offer all doctors potential benefits, including possible savings-based bonuses and, in some cases, greater job security. Because the shift in America to outcome-based care now has considerable momentum, those who adapt early may be better prepared for the changes ahead.

But the good doctors are looking for more than a steady paycheck, and the good physician practices are looking for more than a lucrative buyout. Ultimately, what good doctors want is what good ACOs want too: to help people with higher quality care leading to better outcomes, and to do so while controlling costs, allowing them to help more people.

What do good doctors want? They want to know that you want to help people too, and that you’ll help the good doctors do more.

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[1] “True Physician Leadership Key to Sustainability of ACOs,” Dr. Robert Pear, Modern Healthcare. http://www.modernhealthcare.com/article/20141206/MAGAZINE/312069978

[2] “The Power of Physician Leadership in ACO Success,” Thomas Graf, M.D., FAAFP, and Cynthia Bailey, Accountable Care News, Volume 8, Issue 1, January 2017.