Facility Engagement: Relationships drive change

The Facility Engagement Initiative continues to gain momentum with 69 hospital-based physician groups now organized and leading more than 500 projects across BC. So what is energizing this activity?

Mainly, it’s relationships. My father, who was an obstetrician, worked at the tertiary care teaching hospital in Edmonton. He used to say he would not infrequently see Dr Snell—the CEO of the hospital at the time—in the hallway. If there was an issue to discuss, the two of them would just talk about it. 

Today, doctors may never see the CEO or other senior executives. There’s not a one-on-one relationship anymore, for a variety of reasons. The pressure on resources, staff, and the whole system is so much greater. We can’t expect to be able to stop Dr Snell in the hallway and talk to him about our issues. 

As a result, for the past few decades, physicians have felt that they’ve lost their voice. They are not always asked about critical decisions that impact patients. When concerns arise, often physicians don’t know whom to contact in the health authority structure. After asking the same question over and over, nothing changes, and they stop engaging. I experienced this personally, and have heard it consistently in surveys and interviews with hospital-based doctors. 

That’s why we introduced Facility Engagement. It specifically aims to remove this barrier that doctors feel so discouraged about. It encourages health authorities and doctors to talk to each other and build relationships, and gives physicians time and more opportunity to influence decisions affecting their workplace and patient care. 

We’re optimistic that Facility Engagement is creating an environment for change, but it will continue to take effort on the part of physicians and health authorities. 

How will we know if it is working? When doctors are able to prioritize the issues most important to them and discuss them with the health authority, and say, “We’re organized now. We’d like to be involved.” And when the health authority comes to physicians to ask for input about their 10-year plan or important clinical decisions before they make them, and says, “We should talk to these doctors. They know what they’re doing.”

That doesn’t mean that every doctor will get what they want. But if physicians have a chance to weigh in and be involved, we will make some progress. 

We also realize that doctors need to do a better job of talking to each other about their issues. Through this initiative they are doing more of that, and I hear they are enjoying it.

In my previous role as head of surgery, my colleagues and I agreed to reallocate some OR time from one surgical service to another, based on information that we discussed openly. The group that gave up the OR time realized it was not right that cancer patients from the other service were waiting longer than their own patients who had less-serious problems. 

Supported by good information, we simply talked, and our patients benefited, which, in the end, is the whole point.

Facility Engagement is sponsored by the Specialist Services Committee, one of four committees representing a partnership of Doctors of BC and the BC Government. Read more about Facility Engagement progress at www.facilityengagement.ca.
—Sam Bugis, MD
Executive Director, Physician and External Affairs, Doctors of BC