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How to make a job more than just a paycheck

Understanding physician disengagement

Yanchus, Nancy J.; Carameli, Kelley A.; Ramsel, Dee; Osatuke, Katerine

doi: 10.1097/HMR.0000000000000218
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Background: The benefits of physician engagement are numerous, including improved physician recruitment, retention, and leadership development—outcomes associated with substantial costs or potential savings for health care organizations. However, physician disengagement is a serious detriment, associated with poorer quality of patient care and higher turnover of clinical staff. Using a workforce census survey, we examined what makes physicians engaged or disengaged in their work at a large U.S. health care system.

Purpose: This study expands our understanding of physician engagement and disengagement, states that impact patient care service delivery and care experiences.

Methodology/Approach: We explain group differences using qualitative survey comments from 142 engaged and disengaged physicians, which we report with illustrative quotes and frequency counts of referenced themes.

Results: Engaged physicians discussed positive interpersonal relationships as connected with seeing their work as meaningful. Disengaged physicians expressed concerns about out-of-touch executive leadership. Leadership played a role in psychological safety for both engaged and disengaged physicians: It was described as present and positive for the engaged group and absent for the disengaged group.

Conclusion: There are commonalities and differences in the drivers of physician engagement and disengagement. Our results shed light on why physicians might withdraw from inherently meaningful work. These findings can inform organizational efforts toward decreasing physician disengagement and increasing and maintaining an engaged physician workforce.

Practice Implications: To reduce physician disengagement, we recommend leadership development around key skills (i.e., visibility, transparency, accessibility). We also suggest that improving supervisors’ (e.g., clinical service chiefs’) knowledge about workflow processes, staffing needs, patient panel sizes, and administrative tasks carried by physicians could better balance physicians’ workload. Finally, human resource systems can help reduce disengagement by adjusting hiring and training processes to mitigate low staffing levels.

Nancy J. Yanchus, PhD, is Health Science Specialist, VHA National Center for Organization Development, Cincinnati, Ohio. E-mail: Nancy.Yanchus@va.gov.

Kelley A. Carameli, DrPH, is Health Science Specialist, VHA National Center for Organization Development, Cincinnati, Ohio.

Dee Ramsel, PhD, MBA, is Executive Director, VHA National Center for Organization Development, Cincinnati, Ohio.

Katerine Osatuke, PhD, is Research Director, VHA National Center for Organization Development, Cincinnati, Ohio.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

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