One of the eight keys to a high-performing physician network, culture is the mortar that holds the group together. To be successful, your group must share a common vision and a culture that defines behavioral norms and encourages teamwork and collaboration.

As health systems develop their physician network’s culture, they need to consider two distinct groups of physicians: those who are currently part of the group and those who are joining, or potentially will join, the network.

Physicians in the Network

Network members should be well aware of practice-related expectations. These expectations are components of the group’s culture and should be known, adopted, and shared by all members of the group. They generally include:

  • Productivity Expectations: knowing and accepting the standard number of patient contact hours per week; activities that are considered approved exceptions to direct patient care during designated patient contact hours; the duration of various appointment types that make up the patient contact hours; and who can modify the schedule to accommodate acceptable exceptions.
  • Citizenship: fulfilling completion time frames for medical record entries, telephone consultation closure, and test result review/action; participating as an active member of the frontline healthcare delivery team; and treating other network members and employees with dignity and mutual respect.
  • Quality and Safety Expectations: complying with process and outcome measures; actively identifying and pursuing opportunities for practice improvement; and participating in quality and patient safety improvement initiatives.
  • Customer Service Standards: holding the patient at the center of practice intentions; striving to be on time, focused, and attentive; and exercising service recovery efforts when interactions go poorly.
  • Fiscal Responsibility: completing and submitting encounter coding in a timely and accurate manner; avoiding unnecessary or redundant testing; and cooperating with cost efficiency measures.

Merely setting expectations is not enough.

Measures should be developed, tracked, and shared with the individual providers and aggregate data shared with all staff. The measures should also be incorporated in provider compensation plans in an understandable manner. Performance improvement plans should be implemented when necessary, and those plans should also be measured, tracked, and shared.

Another crucial element to impart to your doctors – and all staff members – is your vision for the group. Start with a high ideal and use this idealistic vision to gauge the validity of operational proposals and group activities. Here’s an example:

“We will diligently strive to build a cohesive physician group that effectively provides high quality, safe, patient-centered care in an efficient manner which is financially sustainable. A group that all members are proud to be a part. A group that is highly respected by the community and is envied by competitors.”

Take stock of your current culture. If your evaluation reveals further work is needed to establish expectations, involve your group’s physician leadership in the process. Direct, early involvement in the expectation development process offers the greatest opportunity to create physician buy-in, because it allows the physician leadership to share ownership. It is their responsibility to lead group acceptance. Buy-in and active promotion by the physician leadership predict the best results.

Physicians Joining the Network

Once the vision and expectations are well defined, they can easily be imparted to physicians and advanced practitioners who intend to join the group. Presenting the culture to potential new members sets well-defined expectations in advance of alignment, adds credence to its importance, permits prospective members to make better-informed decision, and is a tool for determining candidate “fit”.

Once a new provider joins the group, the vision and expectations must be emphasized during the onboarding and mentoring processes by both hospital and physician leadership. One final note: actions speak louder than words. The more the physician leadership reinforces the expectations through their own personal actions, the deeper they are ingrained in the culture.

“We find it useful to get physician leaders to envision an elite group, and think about behaviors and expectations that would permeate such a group. This helps define the expectations for being part of the group.” – Tip 11 from “67 Tips for Developing a High-Performing Physician Network” 

Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks