Why it’s so hard for doctors to change

May 24, 2018

Physicians in practice for many years often find a comfort level with how they run their practice on a day-to-day basis.

Physicians in practice for many years often find a comfort level with how they run their practice on a day-to-day basis. And while these habits may have served them well in the past, the rate of change in medicine requires them to adapt and change the way they do business.

But physicians typically struggle with change, especially when what’s required are complete mindset-shifts, such as moving from fee-based care to value-based care, and dealing with the increasing demands of patients.

This resistance isn’t a personal flaw, it’s a trait of how the human brain works, says Andi Simon, author of “On the Brink: A fresh lens to take your business to new heights.” Simon is a corporate anthropologist who studies how change affects businesses, and has 20 years’ experience as a healthcare and financial executive.

“The brain uses 25 percent of your energy, and is very miserly,” says Simon. “Habits are created and take over so you don’t have to think a lot. Your daily life is driven by habits that deal with low-risk tasks that you don’t even notice.

Doctors have created habits in their practices, created a culture based on those habits and hired people that align with that culture. The physician and the staff go through their daily routine relying on those habits. “When things start to change, the doctor’s initial reaction is to discount it, because it’s painful,” says Simon. “The brain hates to change. There is great research that shows the brain works really hard to deal with change and wants to get rid of that change.”

As a result, the brain likes to hang on to habits, believing that what has always been done will continue to work, even when evidence indicates otherwise.

Learning to change

The brain may resist change, but with the right attitude, physicians can implement the changes they need to improve their practice and better deal with the changes sweeping through medicine. It starts with visualizing a positive picture, says Simon. “They have to change the pictures in their mind so the story is a good one,” she says.

For example, every physician has probably encountered a patient who comes in, having developed a diagnosis from Dr. Google before ever talking to a real doctor. Patients are changing, and one of those changes is treating healthcare like any other product or service. They will research it, form opinions and then seek out care, probably based on online reviews of the provider. Not only will they identify the best provider, they will learn everything they can about their possible ailment to be better prepared to talk to the physician about what they think is wrong.

“The doctor who is angry about this doesn’t need to be,” says Simon. “If you, the doctor, needed something, the first thing you would probably do is Google it and look at reviews and compare. The buyer’s journey in healthcare has changed.”

To cope, she suggests physicians change the way they think about patients who do their own research. Instead of starting an appointment with, “What’s bothering you?” start with, “Have you done research on your ailment and what kinds of things have you discovered?” This creates an approach where instead of criticizing information the patient obtained from Google, the doctor is, in a way, collaborating with the patient in their research. Anticipate that patients will have done prior research and work with them instead of fighting it.

“This is giving patients respect and treating them like knowledgeable individuals,” says Simon.

Change or be left behind

If physicians don’t adapt to these shifts in patient behaviors, they risk losing them, says Simon. “Generation Y wants easy access, they are not loyal, they are looking for something that is readily available and they want an app to see who is available so they can get in and out quickly,” she says. “Those are real drivers of practice success, and millennials offer a whole new set of challenges to doctors.”

Older patients may have notes (possibly from Dr. Google) from their son or daughter to review, and these extended discussions may result in unbillable hours that need to be taken into account when scheduling. Some patients may want to record all interactions with the doctor on their cell phone so they can review instructions later.

“You have to see things from the patient perspective,” says Simon, who notes that search engines aren’t just providing links to medical-advice websites, it’s connecting patients with reviews of doctors. The more a physician can see things from the patient perspective and adapt their habits to cater to them, the more likely their reviews will be positive, which will attract more patients.

Making changes that cater to patient demands might push physicians out of their comfort zone, but it’s important for survival of the practice. “A big part of accepting change is getting over the risk of failure and not wanting to look stupid and fail,” says Simon. “It can take time to learn new ways of doing things, but doctors need to do it, because the changes in medicine aren’t going away.”

Four Tips for Change

For doctors to better adapt to change, there are four things Andi Simon, author of “On the Brink: A fresh lens to take your business to new heights,” says they need to do:

• Accept that the industry is changing and that change is difficult. “They need to come to terms with the fact that they may not like it, but it’s happening.”
• Make the undesirable desirable. “Understand how you change and work on the skills you need to cope.” Do things like working with patients and their Google research instead of fighting it.
• Build confidence. “You need a lot of small wins to build confidence that the new way is better than the old way,” says Simon. “Solutions don’t come in a one-size-fits-everyone. Try something for a week and see how it works.”
• Communicate. “You have to talk and share with people you work with on what the problems are and what the solutions might be,” says Simon. “Ask patients how you can do a better job.”