Surgeons’ influence in hospital purchasing decisions is increasing and that may be a good thing for healthcare organizations, patient outcomes, and surgeons’ professional satisfaction. Not only does surgeon participation direct good decision making, it benefits the organization. Health care systems that operate without physician participation find that change is slow and new initiatives aren’t embraced. Surgeons doubt the success of purchases made without them and in some cases blame poor patient outcomes on the devices bought without their input.
It’s part of the changing paradigm of healthcare. Gone are the days when any medical device could be purchased and the accompanying surgeries ordered without concern for system cost. Now, cost must rule the day and everything else must follow in its wake. Smart healthcare organizations engage surgeons in decision making because to do otherwise can derail efforts to change.
Why? There are several reasons.
Physicians like innovation but only to the extent that it improves patient care. They resist change for change sake, especially when it is perceived to put patients at risk.
Physicians resist unproven systems of care, especially when it adds to their administrative duties.
This is why the latest mobile app or other technological advance is not embraced wholeheartedly by physicians. “New” isn’t good enough. Show proven benefits to patient care and the conversation might begin.
A recent Bain & Company survey, the Front Line of Healthcare 2017, had several reflections on this approach to change.
Management-led organizations that have not fully embraced physician input, for example, have run into resistance or have failed to make a greater impact.
Physicians engaged in decision making are more likely to promote their organizations and to be aligned with their missions, likely leading to better care and outcomes.
Physicians who participated in the Front Line survey said they are “…open to new cost-saving models, but need to be on the frontline of change helping health systems identify which approaches create value for patients, and which don’t.”
Surgeons Are Becoming Sophisticated Buyers
As surgeons become more engaged in purchasing, they are looking at the financial and performance criteria for each purchase. They know who to rely on for vendor information and they understand quality. The Bain & Company survey found:
- More than 80% of surgeons and procurement officers say they work in collaborative partnerships to purchase medical equipment, weighing clinical and economic value together.
- 43% of surgeons now believe their procurement department improves costs and quality of care while allowing surgeons to use the instruments and implants they want.
- More than 60% of surgeons rank “strongest existing relationship” with a manufacturer as a key purchasing criterion, up from 46% in 2015.
- Surgeons’ top criteria for medical equipment are product quality and patient outcomes.
- 70% of surgeons believe “best value for price paid” is an important purchasing criterion, a significant increase more than two years ago.
The Benefits of Surgeon Purchasing Decisions
When surgeons are engaged in the financial and procurement process, they also tend to become advocates for the system in which they work. The Bain & Company survey found that among surgeons who are involved in finance and procurement:
- 54% of them are positive about their organization as a place to work.
- For surgeons who are not involved, only 22% feel it’s a good place to work.
- When it comes to whether or not their organization is a good place to receive care: 65% of engaged physicians rank it positively.
- Only 53% of non-engaged physicians feel their organization is a good place to receive care.
A study published in The International Journal of Technology Assessment in Health Care shows the importance of involving end users in the purchase of surgical instruments and devices. The study collected data from 186 orthopedic surgeons, 86% of whom were involved in buying decisions. Regardless of their involvement, 92% of the surgeons stated that clinical practice was “negatively influenced” by purchasing. They said problems included “material failure; effectiveness of medical devices; obsolete medical device technology; incomplete provision of implant/ instrument sets; delayed provision of implants and instruments.” The only way to address that is to increase the participation of surgeons in the assessment and purchase of those materials.
As the Bain & Company survey said, “Those who have a say in management decisions are much more satisfied with their working environment and more willing to lead change.” Every healthcare organization in the US must continue to change if it is to survive. We need leaders who can push the system toward reduced costs and improved patient outcomes. If surgeons are those leaders, it behooves healthcare administrators to engage them, rely on their input and use it to improve the system as a whole and the patients it serves.
