This month's issue of Healthcare Executive (subscription required) features a column by Joseph S. Bujak titled "Approaches to Influencing Physician Behavior." It's adapted from Dr. Bujak's book, Inside the Physician Mind: Finding Common Ground with Doctors. The column lists six approaches; I want to highlight two that I found especially insightful.

First, Dr. Bujak writes, encourage self-discovery and self-interest. This can be achieved if you know a physician's values—but too often these are not evident even to the physician herself. Consider asking physicians to participate in a self-assessment exercise. Once these values are known, physicians can consider changes in their behavior that allow them to better adhere to their values and thus better serve their self interest.

For example, Dr. Bujak cites six values that many physicians desire professionally: respect, control, fair reimbursement, efficiency, improvements in patient care, and time. If hospital leaders can articulate that changing physician behavior will be mutually beneficial, the physician will consider the change. It's important to remember that values often exist in a hierarchy; if a physician values control more than time, it's unlikely that he or she will relinquish control for flexibility.

Second, the article discusses the importance of knowing your physicians and how likely they will be to consider changes. Dr. Bujak cites consultant Tom Atchison, who has organized the physician community into five distinct groups. "Proactive leaders" are potential early adopters (or perhaps "champions"?) willing to work with new ideas and modify them to their work conditions. "Reactive leaders" are those willing to adopt new behaviors but not pioneer them. "Uncertains" are those who can be convinced to adopt new behaviors if properly nurtured. "Skeptics" are critical thinkers that point out negative aspects but who can be "converted" if these aspects are addressed (and then become a powerful force along with "proactive leaders"). Finally the "cynics" never offer a positive or useful contribution. Organizational leaders too often ignore "uncertains" to concentrate on the cynics. Leaders should focus on those willing to enact change, or at least engage in a productive dialogue, and not get bogged down with naysayers.  

Dr. Bujak writes that Dr. Atchison builds on the work Everett Rogers and the science of dissemination, briefly profiled here last March.

At first glance, I thought Dr. Bujak might just offer a mishmash of John Kotter and Jerome Groopman.  But after reading his column, he has unique and pragmatic ideas for how to partner with physicians—vital to encouraging the change that we need to improve quality.