How can you resolve conflicts with change-resistant physicians?

First, eliminate the term "change resistant" from the educational materials. This term assumes a negative about the physician that may not exist, as well as an implicit bias on the part of the change agents. It also assumes that the change being discussed is a positive for the physician and the organization. How do you know this? As the previous contributor states, you need to understand and respect the physician's experience and viewpoint. All change is not necessarily positive for all involved. Have the hard data to show how this change will actually benefit the organization/practice. Don't assume that changes, because other organizations are making them, are automatically a good thing. Change for the sake of change rarely is.

Agree with prior MD contributors that this article is framed with severe bias & lack of empathy for MDs. First off, understand that practicing physicians own ALL the liability. If you add risk to that profile, the conversation is done. Second, physicians are licensed and certified to standards. Are they perfect? No one is but those standards require making evidence based decisions and staying up to date on latest evidence by way of CE. If you do not have a track record of performing at a similar level of understanding evidence and liability; you will have no influence to affect change in physician behavior. Physicians absolutely change, it's dictated by the scientific method. They change with new evidence and competent change management.

As previously stated the change has to be good for patients first. The for physicians and finally organizations. Physicians are “captains of the ship” and although over the years there has been more collaboration among physicians and other providers, physicians are still the one ultimately responsible for the outcomes.

Resolving conflict with providers resistant to change involves respect, education, & communication. First to acknowledge the provider's current workflow, highlighting all that it has achieved, show the pros & cons of a current approach, then highlight the room for improvement. Next, utilizing education materials to assist the provider in recognizing alternative methods available for completing certain tasks, showing the benefits of updating software or re-organizing staff & tasks to eliminate redundant or inefficient patterns. Lastly, ongoing communication regarding improvements needed & how utilizing different products or restructuring the workflow may benefit the patient or revenue cycle in keeping with the provider's mission statement.

Change-resistant physicians is framed like diabetic patients. Many patients with diabetes resist change and/or lack of motivation to change. Physician resist change and lack motivation to change for a broad array of good and dubious reasons. Many tenets of motivational interviewing are described above.

If you approach a physician without data/evidence of your intervention’s efficacy you will hit a brick wall of resistance. That’s just the way we’re trained to think. And rightfully so. We don’t experiment with our patient’s wellbeing.

Be very careful about claims of improved outcomes, very careful. Outcomes are predominantly about patient factors shaped over a lifetime of influences, not something that can be done in a few minutes of patient contact over a year with a delivery team member. Do you support more and better delivery team members to optimize their ability to influence change, within the limits of what the patient can change? Or does your budget shaped by CMS, states, and privates and employers shape fewer and lesser delivery team members? You can bet that CMS, states, private insurance, and employers are most distant from patients and one on one interactions - and team members might be right and changes might be wrong.

Effective communication is paramount to ensure change acceptance. In AI and healthcare, change often brings improved patient outcomes, efficiency, and safety. Presenting data-backed benefits and testimonials from other physicians who have successfully embraced change can inspire more acceptance. For instance, sharing success stories of AI tools improving patient outcomes can reassure physicians about change implementation.

Always include stakeholders in any change process. When they give input and feedback and have a say in how things will work you have automatic buy in.

Participation is a strong motivator for change acceptance. In my experience, physicians actively involved in the change process - from planning to evaluation - are more likely to support the change. Analogously, AI models are continuously improved through input and feedback, resulting in more effective solutions. By adopting a similar approach, physicians may feel more invested and receptive to change.

Create a just culture. Plain and simple. No one is going to open up, give feedback, accept criticism, without a feeling of psychological safety.

Supporting physicians through the transition is crucial. Providing adequate training and resources can ease the learning curve associated with new practices or technologies. For example, if an AI solution is being introduced, providing comprehensive training on its usage and benefits can reduce resistance and promote acceptance.

Autonomy is a universal human need, not confined to physicians. All individuals appreciate having influence over decisions that impact them, boosting motivation, job satisfaction, and well-being. In healthcare, respecting physicians' autonomy honors their expertise and meets a basic human need. By extending this respect to all team members, leaders can create an environment where everyone feels heard and involved, improving the success rate of change initiatives. This principle applies across all sectors, enhancing the effectiveness of any change management strategy.

Respecting the autonomy of physicians is vital. Each physician has a unique style and pace of learning, and acknowledging these differences can facilitate smoother change implementation. By providing flexibility in how they adapt to change, we respect their professional judgment and foster a collaborative relationship.

Allow TIME for change to occur: It takes time to change and relearn new habits. So be sure to have a change management plan that allows most (if not all) physicians to move at their pace of change to increase buy-in and adoption. This change management plan should also adjust for time & effort to address resistance to change.

In my experience, respecting physician autonomy is your first step, and finding common ground is your critical second step. Whatever change you’re proposing, it most likely aligns with a shared value. Find out what that is and build from it. For example, if your change is to implement a new process with the goal of increasing wellness screenings, build from the fact your physician wants to see improved health outcomes through early intervention. I have faced the most resistant and challenging physicians out there, and I’ve brought all of them around to embracing change by finding that common ground, whatever it may be.

In 2023, after COVID-19, I feel in retrospect, public health (which I represent) failed our physicians. We said, "Change the way we want you to," it didn't work, and public health lost credibility. Now, I feel it is not illogical for physicians to push back. Let's ask ourselves: Why do we want this change? The healthcare system has crashed, and no one is fixing it (at least in the US) - so does this little change really matter? What about the high level of clinician burnout and attrition? Is it worth badgering these people to change in some KPI-inspired way? Maybe if we can find compassionate ways to support physicians (and all clinicians these days), and not try to make anyone change for a little while, it might be a better approach.

As an APRN, it places me in a very difficult position working with a physician who declines to treat patients by newer evidence-based guidelines. Sadly I see this on a daily basis.