How to Discourage a Doctor

The official unofficial playbook:

“Make health care incomprehensible to physicians. It is no easy task to baffle the most intelligent people in the organization, but it can be done.”

“For example, make physicians increasingly dependent on complex systems outside their domain of expertise, such as information technology and coding and billing software.”

“Promote a sense of insecurity among medical staff. A comfortable physician is a confident physician, + a confident physician usually proves difficult to control. To undermine confidence, let it be known that their jobs are in jeopardy + their compensation is likely to decline.”

“Transform physicians from decision makers to decision implementers. Convince them that their professional judgment regarding particular patients no longer constitutes a reliable compass”

“Refer to such decisions as anecdotal, idiosyncratic, or simply insufficiently evidence-based. Make them feel their mission is not to balance benefits + risks against their knowledge of particular patients, but instead to apply practice guidelines to the care of all patients.”

“Subject physicians to escalating productivity expectations. Borrow terminology and methods from the manufacturing industry to make them think of themselves as production-line workers, then convince them that they are not working sufficiently hard and fast.”

Increase physicians’ responsibility while decreasing their authority. For example, hold physicians responsible for patient satisfaction scores, but ensure that such scores are influenced by factors over which physicians have no control ..

Above all, introduce barriers between physicians and their patients. The more directly physicians and patients feel connected to one another, the greater the threat to the hospital’s control.

https://thedeductible.com/2020/06/17/how-to-discourage-a-doctor

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