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Why High-Performance Medical Groups Prioritize Culture

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What makes a high-performance medical group high-performing?

Is it the group’s Patient CSat or Provider NPS scores? Its Quality Score in the Medicare Shared Savings Program? STAR Rating? Utilization rates? Is there an ideal equation that aggregates and weights these variables to calculate a more comprehensive and true measure of performance?

I think the more important question is, which qualitative factors does this quantitative view overlook?

In a word: culture.

As my colleague Keith Fernandez, MD, astutely noted: “When creating a physician network, culture and alignment are critical.” I wholeheartedly agree. When evaluating a medical group’s performance, precise and objective measures are essential but incomplete. Culture is the X factor that drives results and enables long-term success.

With that in mind, the question then becomes: What are the cultural dimensions of a high-performance medical group?

  • Prioritizing the Doctor-Patient Relationship
  • Fostering Transparency
  • Promoting Multifaceted Accountability
  • Enhancing Engagement


Prioritizing the Doctor-Patient Relationship

Performance and outcomes are undoubtedly, inextricably linked. However, fixating on positive outcomes can paradoxically decrease their likelihood. Why? Because narrowly focusing on the end goal risks ignoring the doctor-patient relationship.

The trust, connection, and communication at the heart of this relationship can improve patients’ health. This is not merely a feel-good sentiment; this is an empirical observation. Research shows that effective “physician-patient communication has been shown to positively influence health outcomes” across several key areas:

  • Increased patient satisfaction
  • Greater patient understanding of their health and care options
  • Better adherence to treatment plans

So how can high-performing medical groups enrich the doctor-patient relationship?

Start by removing administrative burdens so physicians can dedicate more time and attention to patients. For instance, a medical group can contract with a management services organization (MSO) to assist with its members’ IT, billing, and revenue cycle processes. Next, the group can invest in and deploy technologies that help enhance connection and satisfaction.

These technologies may include a virtual scribe to help reduce physicians’ electronic health record (EHR) workload and distractions during patient visits. Another useful tool is a robust patient portal that allows for secure messaging, prescription refills, direct appointment scheduling, and closing care gaps through proactive patient outreach.

There are many strategies and digital tools to bolster the doctor-patient relationship. While each medical group will choose what’s best for its needs, members, and patients, all groups should remember that outcomes are the culmination of this relationship. Ultimately, if patient care is held at the core of a medical group, positive patient outcomes follow.

Fostering Transparency

The doctor-patient relationship isn’t just a component of medical groups’ performance, it’s also the perfect analogy for my next point. Imagine creating a treatment regimen for a patient. Would you rather this patient withhold or openly share their health information? And during this patient’s follow-up visits, would you rather they fib and tell you that they followed every step perfectly or honestly report their progress as well as issues so you could adjust their regimen accordingly? In both scenarios, the latter is clearly preferable and demonstrates trust, connection, and transparency in the relationship.

Transparency is similarly vital to medical groups as it promotes engagement, trust, satisfaction, and alignment. If you want to build a high-performance medical group, start by building an open and comfortable culture. Create an environment where members can freely share their perspectives and easily access important data and information. Make space for crucial conversations around quality scores, utilization, and provider-retention rates. These steps cultivate transparency, which in turn leads to improvement. After all, a map isn’t useful if you cannot place yourself on it.

Transparency should be at the core of a medical group’s physician governance. These transparent, physician-led meetings are critical to success. “[W]e openly broadcast participants’ metrics,” shared Fred Taweel, MD, Chief Medical Officer of Privia Medical Group — Mid-Atlantic. “This leads to positive conversations, with leaders sharing action plans and best practices that build buy-in and effect change. Our discussions are always constructive. The atmosphere is collaborative yet competitive, creating the conditions under which we as healers so often thrive.”

However, transparency doesn’t start and end with a medical group’s meetings. It’s critical that these updates also reach practice administrators and front-office staff so that everyone involved is informed of updates and progress. This involvement is crucial for practices to effectively adjust their workflows and operations.

Beyond transparency’s role in physician governance and practice operations, it is also a key enabler of the two final cultural dimensions I’ll explore in my next post. Check back next week as I explore the necessity of accountability and engagement.

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