Dr. Roger Gerard's career journey has spanned various industries as an author, management consultant and healthcare leadership expert. His early days were spent with the Michigan Heart Association and the American Cancer Society before working his way through hospital systems and eventually being promoted to chief learning officer. Having witnessed firsthand the evolving challenges facing healthcare professionals, Dr. Gerard explains that the root of these challenges lies in the “commodification” of healthcare providers. He noted that the autonomy and intrinsic motivation of medical practitioners are being eroded by increasing standardization and external control.
"Professionals want to practice their profession, and when a physician today can only spend seven minutes with me in my primary care visit, and it takes another 15-20 minutes to write up the report on that seven-minute visit, and he doesn't get to ask all the questions that he wants to ask, and I don't get to ask all the questions I want to ask, nobody's happy," Dr. Gerard laments. This loss of autonomy, he argues, is a direct result of the healthcare industry's relentless pursuit of cost control and standardization, often at the expense of the professional's ability to provide personalized, high-quality care.
Leading with Purpose
In his latest book Lead with Purpose: Reignite Passion and Engagement for Professionals in Crisis, Dr. Gerard explores this concept to help restore the intrinsic motivation and autonomy of healthcare professionals. He emphasizes that healthcare organizations are "communities of practice," where the human element must be at the forefront of leadership strategies. "Businesses are communities of practice," he explains. "And if we understand that businesses are communities of practice, that means they're human, and if we aren't careful, we will take the humanity out of the business."
The Limitations of Incentives
One of the key challenges Dr. Gerard identifies is the overreliance on incentives as a primary means of addressing professional needs and wants. He argues that while incentives may provide short-term boosts, they ultimately demoralize healthcare providers by shifting their motivation from intrinsic to extrinsic.
"When you do that, you're doing a couple of things. First of all, you're changing the marketplace, and so everybody has to raise the level of the water. It just it's crazy," he says. “And suddenly you've got this same kind of craziness where the level of water goes up and you're spending all this money and nobody's winning.”
Five Promises for Positive Change
To combat this issue, Dr. Gerard outlines five "promises" that leaders can make to cultivate a positive organizational culture and restore purpose and autonomy among healthcare professionals. These promises include:
- Listening with respect
- Helping professionals learn and grow
- Ensuring their success
- Providing competitive compensation
- Having their backs during challenging times
By making and keeping these promises, leaders can build a relationship of trust and loyalty with their healthcare teams, empowering them to be "co-authors" in their daily work.
Practical Advice for MGMA Members
For MGMA members and medical practice leaders looking to implement these strategies, Dr. Gerard offers practical advice. He suggests that leaders "go and see" – observe the daily work of their professionals without the intent to find and fix problems, but rather to understand the realities on the ground. Additionally, he encourages leaders to "go and do" – empower their professionals to solve problems and make decisions, tapping into their expertise and intrinsic motivation.
"If you make those five promises to people and then keep them, you're going to have a relationship that's loyal and it's going to last over time. That's the kind of relationship you want to cultivate," Dr. Gerard emphasizes. By embracing this approach, healthcare leaders can foster a culture of trust, engagement and purpose, ultimately benefiting both their medical practitioners and the patients they serve.
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