Practice Notes

Six physician personas every executive will recognize

by Anita Joseph and Rivka Friedman

Since the Medical Group Strategy Council's launch three years ago, we've been talking about the challenge of managing across disparate physician practices. Each practice fosters different skills and personalities and requires a different management method.

Acknowledging these differences can help executives adjust their management tactics to meet both their clinicians’ and medical groups’ needs. With this in mind, I propose a few distinctions worthy of attention. Read on for a look at opposing physician characterizations that you might recognize—and see what other groups are doing to support these various personas. 

Trying to 'change your medical group culture'? You're already doing it wrong.

Digital natives vs. digital adaptors

"Digital native" physicians easily adapt to the EMR. They write enough in the patient note to achieve clinical objectives but not so much that the work drags down their daily schedule. They are comfortable interacting with their patients via email and telephone and embrace virtual consults.

In comparison, "digital adaptor" physicians struggle to manage electronic work demands—this group is characterized as having lower typing speeds, difficulty with the EMR user interface, and trouble balancing electronic and live patient demands.

Sentara Medical Group acts on this distinction by varying their EMR training methods across their physician cohort. They offer weekend training, classroom modules, onsite support, and a physician helpline. Each method is used for different professional development needs.

Related study: From Meaningless to Meaningful

Superproducers vs. threshold workers

"Superproducer" physicians are motivated deeply by production demands. They are willing to work evening and weekend hours to increase their clinical visits and prefer tiered RVU compensation.

On the other hand, "threshold workers" are motivated by both clinical objectives and a desire for work-life balance. They prefer threshold-based RVU compensation and resist nontraditional hours.

Leadership at Redwood Medical Group, a pseudonym for a group on the West Coast, uses this distinction to distribute primary care roles to physicians. Redwood offers superproducers roles in traditional primary care offices and keeps them on progressive RVU compensation. It offers threshold workers roles in its urgent-care centers, where they received shift-based salaries.

Coaches vs. quarterbacks

Coach" physicians see themselves as the leader of the care team and the owner of the patient relationship. They take on the responsibility of supervising and managing other providers.

In contrast, “quarterback” physicians see themselves as a member of a care team of peers who are collectively responsible for patient relationships. They may "call the play" but then hand off responsibility for the patient to another provider.

Realizing Full Value of the Care Team

Many medical groups are restructuring compensation to incent "coach" or "quarterback" behavior from PCPs. A “coach” compensation model might offer PCPs a set annual amount to supervise APs, or pay PCPs a fee for each RVU generated by an AP. In contrast, a “quarterback” compensation model might ask APs to cover a portion of the PCP’s practice costs or involve PCPs and APs in profit sharing.

Do you agree with these distinctions? Are you managing your physicians based on cohorts? What other different groups of physicians have you identified within your medical group?

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