Driving Forces

To make a dent in spending on physician-preference items, tap into doctors’ desire for data, and don’t check trust at the door

Editor’s Note: The participation of those in the following article does not constitute an endorsement of the sponsor’s products or services.

Nobody said that gaining control of physician-preference items is a simple task. However, when you start feeling bogged down, try to keep three guiding principles in mind:

  • First, involve physicians in supply chain issues early and often.
  • Second, to effect change, present your physicians with reliable and timely data.
  • Third, trust your physicians to take cost issues to heart.

This advice comes straight from the horse’s mouth, that is, a panel of physicians at this summer’s 47th Annual Conference and Exhibition of the Association for Healthcare Resource & Materials Management (AHRMM) in Tampa, Fla.

Moderated by Nick Sears, M.D., chief medical officer, MedAssets Inc., Alpharetta, Ga., the panel included Jodi Chambers, M.D., chief medical officer, Centura Health, Denver, Colo; Mark Weaver, M.D., chief medical officer, Memorial Health System, Springfield, Ill.; and John Kontor, M.D., physician director, clinical content, Bon Secours ConnectCare, Bon Secours Health System Inc., Marriottsville, Md.

What drives docs?
“Engaging physicians has been a challenge for this industry for eternity,” said Kontor. “The question is, ‘What drives physicians?’ Pessimists might say it’s money, and that’s certainly important. But I believe strongly that physicians are primarily driven by providing good care. I believe [materials managers] can leverage that to become partners with them to improve the way we deliver care, to create a partnership, and to reduce costs.”

Indeed, materials managers are ill-advised to start a discussion about products and technology with “We can save X amount of money,” said the panelists.

“Clinical benefit is always No. 1,” said Weaver. “We’ll never tell our doctors we won’t do something for patients because of cost, if it will result in better care.”

That said, many materials managers underestimate how cost-sensitive doctors are, said Weaver. Memorial gives its physicians regular cost-of-care reports. “Physicians understand profits,” he said. “If [a service] is not profitable for the hospital, they’re very understanding of that.”

Physicians tend to like to be “leaders of the pack,” said Chambers. “But they don’t want to be the one who’s costing more or whose patients have the longest length of stay – unless they can show that their population is truly different and requires a different approach [to care].

The data’s not there
“The problem most of us have is that the data is not there,” she continued. “We’re struggling with getting data in a timely fashion. It has to be real-time and meaningful. And docs have to be at the table helping interpret it. So you need good data; you need doctors at the table making sure you’re not making false assumptions; and you need to define the parameters and make sure everybody agrees on them.” Cost as a percentage of reimbursement is a meaningful parameter, she said. “If [a device] costs more than what the hospital is getting reimbursed, that’s meaningful.”

But doctors need other data, such as information about length of stay, said Chambers. A device – say, an implant – that costs more upfront but that results in shorter lengths of stay might be preferable to one that costs less but that results in longer lengths of stay. The point is, everybody has to be on the same page about what data should be measured and how it should evaluated.

That said, purchase price is an important consideration, and one in which doctors are interested. But at the same time, “Your relationship with physicians shouldn’t be formed when you have to go to their door and ask them to use a less expensive product,” said Kontor. “Engagement with the clinical staff has to occur around clinical issues; that’s what draws them to the table. If you get them to the table to talk about those issues, and then bring in supply-related issues, you’ll be much more effective.”

In many cases, physicians – when given good data to work with – will work out supply chain issues amongst themselves in a way that pleases both the clinical and administrative sides of the house, according to the panelists. “Physicians often don’t know what the costs [of technology] are to the hospital,” said Chambers. “Get them to the table, let them see the data, then let them talk about why one physician prefers one item over another. Get them to compare results. Let them know that variation [in equipment and devices] leads to downstream problems. When they start to see all that coming together – the benefits of reducing options, reaching better price points, seeing how they’re doing compared to their colleagues – you’ve set up a good environment.”

Nowhere to hide
Finally, don’t be afraid of your physicians. The fact is, doctors know that if their hospital is dealing with cost issues, their competitor down the street is probably doing the same. So, in a sense, there’s nowhere to hide in today’s market.

“I believe very strongly that part of the problem in healthcare is the fact that CEOs tend to look at the physician as a customer,” said Chambers. “Don’t get me wrong: Physician satisfaction is a very important thing, as is patient satisfaction and employee satisfaction. But physicians need to be treated as partners, not customers. When you have an important part of the equation being treated differently than others, and when people are afraid about how the doctors might react to a [proposed] change of products,” you’ve set yourself up for failure, she said. Doctors resent administrators reverting to old stereotypes and assumptions, such as, “They’ll blow up if we try to get them to change products.”