Patient and Physician Engagement - the Missing Step

Posted by Dike Drummond MD

Patient and Physician Engagement - the Missing StepPatient and Physician Engagement - the Missing Step

We are entering healthcare’s Age of Engagement- and something is missing.

In this article let me show you the missing link to patient and physician engagement. Understand this engagement blind spot, and you will immediately upgrade your effectiveness as a clinician and physician leader

The Quadruple Aim Blueprint White Paper Download
Four Steps to System-Wide Burnout Prevention
Download your Free Copy Now

Engagement definition:
The full and enthusiastic participation in a course of action.

Patient Engagement - Physician Engagement - Employee Engagement. All organizations are working to bring their staff, physicians and patients into a position of full engagement with their jobs and their healthcare. You already know enthusiastic participation cannot be ordered, mandated, forced or simply expected. Here’s the reason most engagement efforts fail.

To create engagement you must leap a separate hurdle first - one you probably don’t see until I show it to you right now. 

The Missing Step is ENROLLMENT

Enrollment is the act of saying YES to the benefits your program will provide, whether it is a treatment plan for a patient or a new corporate initiative for your staff and providers.
People must be enrolled, bought in, "sold" on what you want them to do FIRST, before they will become engaged in the steps of your plan. 

It must be THEIR DECISION TO ENGAGE ... based on one timeless principle of human behavior ...

physician leadership dirty little secret

What's In It For Me (WIIFM) 

Here is the fundamental error 98% of leaders and physicians make when trying to create engagement ... you completely fail to enroll the person first.

You wade in, giving orders left and right expecting your patients and staff to simply fall into formation and do exactly what you tell them. When they don’t comply ... you wonder what is wrong with them. You wonder why they are not more engaged.

Time to look in the mirror. If your people are not engaged it is because you failed to enroll them first.


Enrollment helps your patients and staff complete these two critical steps:

Patient and Physician Engagement - the Missing Step1) Understand WHY they would participate

Don't just blurt out what you want them to do, in a rushed set of orders ... with no process to enroll them as to WHY first. Even worse, do not say something like, "You need to be more engaged here" ... Yikes!

If they don't understand WIIFM first, you are simply giving them orders. Since this is not the military, you are giving them a clear choice ... comply or ignore.

Most of the time they will ignore and resent you trying to tell them what to do.

2) Make a choice to participate ... a choice to ENGAGE in your program

Remember this; Engagement is a CHOICE.

When I understand what's in it for me to participate in this program I can choose to engage or not. It is my choice. If you order me instead of helping me choose, you just shattered your chance at engaging me.

The #1 Skill of Enrollment is EMPATHY

If you want your program to succeed in engaging your target audience ... whether this is
Patients, Staff or Physicians ... you must exercise your empathy muscles. You must put yourself in their shoes and figure out WHY they would want to engage in your program. Answer the question "What's in it for me?" from their perspective.

How will they benefit by participating?

Identify the benefits to THEM. List the benefits. Explain the benefits. SELL the benefits FIRST. When they see the benefits and can clearly identify WIIFM -- only then can they make a decision to participate and engage in your program.

You must enroll them FIRST - before you can expect any engagement at all.


Power Tips:

You can identify the benefits of your program in two ways.

1) Put yourself in your target audience's shoes and try to figure it out on your own. This is what most people do and it is only partially effective.

2) Ask the people you are targeting what the benefits of your program might be. Let them help you design the enrollment process.

Explain your program to a small group of the people you want to engage. Have THEM tell you how that would benefit them. You can even ask questions about how they would recommend you might improve your program. Then use these benefits and WIIFM to enroll your target audience.


Two Examples:

1) Patient Enrollment
2) Physician Enrollment


1) Patient Enrollment:

Let's say we are talking about a patient. You are enrolling them in their treatment program.

- Explain their disease and its course and complications
- Explain your treatment plan and how it affects the symptoms and course of the disease
- Then ASK THEM how that would benefit them personally

Once they have identified how they would benefit ... they will have enrolled themselves in following the plan. You simply ask them if they are ready to get started.

Sample Dialog:

"Well Mrs. Smith, you have high blood pressure I would recommend we begin to treat with medication and some other steps that should bring it back under control. The benefits of bringing your blood pressure down to normal are protecting you against heart attack and stroke and potentially helping you live a longer happier life.
As you think about this ... what benefit do you feel this would be to you?"

"Well, Dr. Drummond, I sure don't want to have a stroke. It would give me more time with my grandchildren and I still have some traveling to do."

"It sounds like you have some very good reasons to treat your blood pressure. It will be important to remember these reasons WHY ... as you begin to take the steps to bring your blood pressure down. So are you ready to get started ?"

"Yes I am Dr. Drummond ... what are the steps."

In this case Mrs. Smith is enrolled first. She knows WIIFM from both a medical and personal perspective. She has chosen to engage in the treatment plan before we even outlined the components.

New call-to-action

2) Physician Enrollment:

Let's say you are designing a quality metrics program for your physicians. You are proposing your providers track a specific set of metrics for all patients. The benefits you have identified are: increased care quality and bonus payments from insurers when physicians reach certain quality thresholds.

Don't make this mistake.

Don’t mandate the program without enrolling the physicians first.

If you mandate without enrolling them first, you will meet resistance and create a wave of bad blood that will hamper your change efforts for years to come.

physician engagement physician enrollment key is wiifmRemember ENROLL them first

You must answer the question WIIFM as a physician to participate.

You know increased quality and higher incomes are a place to start. Over communicate these two points AND ask questions too. Here's how it might play out when you talk with a couple of your physicians prior to rolling out the program.

The Quadruple Aim Blueprint White Paper Download
Four Steps to System-Wide Burnout Prevention
Download your Free Copy Now

Sample Dialog:

"We are proposing our new Quality Metrics Program to help us improve quality and be eligible for bonus payments from select insurers when we reach their milestones. What other benefits can you see to you and the rest of our providers from this program?"

Doctor A:
"We could prevent people from falling through the cracks on preventive care. But just remember we can't be asking the doctors to be responsible for documenting all of this. They are overloaded as it is."

"We think there is a way to coordinate nursing and medical records to do all the tracking."

Doctor A:
"That might mean the doctors job gets easier ... because they are not trying to remember the guidelines and searching for the information in the chart all the time."

"So that makes the benefits, higher quality, more income, making sure patients don't fall through the cracks, and not having to work any harder to achieve these benefits"

Doctor A:
"I guess you are right ... that makes it feel pretty worthwhile to get started. When can we look at the details of the action plan?"

Here your physicians have helped you identify additional benefits of participating in this new program. You are building physician engagement from the ground up and they are helping you design a more effective enrollment process.


Remember - If you want Engagement, you must start with Enrollment.

Engagement cannot be ordered, mandated, forced or simply expected. Patient and physician enrollment must happen first. Enrollment is the act of saying YES to the benefits your program will provide, whether it is a treatment plan for a patient or a new corporate initiative for your staff and providers.

Plan for Enrollment. Get very clear WIIFM and over communicate these points. Give them a chance to choose to engage FIRST. Ask questions to allow your people to help you design the enrollment process.

When you can clearly see this missing step to Engagement, you can take the steps to create the enrollment you seek.



What is your experience with enrollment and engagement of patients, staff and physicians and what tips would you like to share?


Tags: Physician Engagement, Physician Leadership