Collaborative Compact

I  enjoyed reading “Physician Compact: A Tool for Enhancing Physician Satisfaction and Improving Communication” so much that I spoke with Dr. Sanjeev Shukla, the principal author and Regional Medical Director of the Wheaton Franciscan Medical Group in Milwaukee, WI to obtain more information.  The article was published in the Physician Executive Journal of Medical Management. 2009; 35(1):46-49.  Dr. Shukla wrote:

We needed to improve physicians’ collaboration in achieving strategic goals of the medical group. We felt that the compact can be used by physicians and leadership to carry out crucial conversations that are inevitable at times to resolve the conflicts and facilitate much needed collaboration. We also felt that the compact will promote value-based behaviors among the physicians. The compact is an informal understanding between the physicians and the medical group leadership as to what physicians expect to “give” to the group and what physicians expect to “get” from the group in return. It is a social contract and not a legal contract.

The compact is outlined below.  What impressed me was that it was a bottom-up process that began April 2007 with a group of seven physicians, a facilitator, and a member of the physician recruiting team who engaged in spirited discussions about the behavioral elements to include in support of their values of respect, integrity, development, excellence, and stewardship.  The group reached consensus in October 2007 and presented the draft to three department chair councils and to physicians in all the departments to obtain their suggestions for improvement.

The compact group assured all physicians that their input mattered.  After the group discussed physicians’ suggestions and finalized the compact, they shared it with the department chair councils, Operations Executive Team, and Board for approval prior to roll-out, April 2008.  A physician remarked:

My initial thoughts were filled with skepticism, as I did not understand the purpose of it. However, after reading through it, I think it is a great outline of the commitment, expectations, and goals of the organization. If we see this organization as physician led, then the foundation needs to be laid down. The compact is a great place to start in addressing the mission and the goals of the organization. Also, the philosophy and expectations of the organization are spelled out to the physicians, staff, and patients. The compact makes expectations crystal clear in my mind.

A hospital leader was equally supportive:

I believe the compact provides a foundation for physicians and administration to build from at WFMG. It outlines the responsibilities of both parties which supports the mission vision and values as well as open communication. I also believe it is an important message for our patients and demonstrates being  a physician-led organization. Most physicians have been supportive of the compact. A few have been supportive at compact signing but have been negative or made fun of the compact in private. I believe it is a very positive move that can differentiate us as a medical group to attract future hysician recruits or acquisitions.

As the authors noted, practicing medicine requires that physicians support one another while adjusting to disruptive changes in the healthcare marketplace.  The compact helps physicians and administrators come to a shared vision to serve their patient community and achieve organizational goals.

I wrote in Before Alignment that the journey to alignment of goals and values requires transparency, engagement, and co-mentoring.  Collaborative Co-Mentoring implies that each person brings valuable knowledge, skills, and experience to the table.

Dr. Shukla remarked, “The physicians in the compact group and the department chair councils did a fantastic job.  They are truly physician champions!”  I wrote in Collaborative Champions:

Physician champions are outstanding clinicians who have earned the respect of their peers by caring for patients in a consistent and reliable fashion, delivering great clinical outcomes.  They are the people we turn to when we need medical care.  They are also seasoned professionals looking to leverage their knowledge and experience to improve care for their community.  Possible roles for physician champions include:

  • Presenting and discussing clinical data with fellow physicians
  • Minimizing physician-hospital battles
  • Creating a safe environment for learning
  • Helping to build transparency and trust

What do you think?

  • Is the above process a journey worth taking
  • What steps are critical to make sure that physicians feel that their input truly matters
  • Can a compact help an organization to differentiate itself in a competitive marketplace

The following is a compact of the value-based behaviors for physicians and organizational leaders paramount in making Wheaton Franciscan Medical Group a world-class quality patient care organization:


• Actively listen, communicate, share ideas, and support physicians.
• Create a working environment that is open, trusting, respectful, and fulfilling.
• Support physician wellness.
• Acknowledge physician contributions to patient care and the organization.
• Be transparent in the decision making process.

• Manage the organization with integrity and accountability.
• Share information openly regarding business decisions, strategic intent, and organizational priorities.
• Provide opportunities for collaboration in decision-making about all issues that affect physician practice.
• Keep physicians informed via timely and honest communication.

• Provide the resources necessary for practice improvement.
• Offer opportunities for constructive dialogue.
• Provide clear expectations, regular evaluation, and feedback.
• Support career development for all physicians and staff.

• Create and maintain a patient-centered service culture.
• Provide adequate resources, processes, and environment to achieve quality care and service excellence.
• Recognize and reward practice and service excellence efforts by physicians.

• Provide fair market compensation.
• Recruit and retain excellent physicians and staff who share the vision and values.
• Reward physician efforts leading to service, operational, and quality excellence.
• Support involvement in community activities and service.
• Promote health, safety, and security in the workplace.
• Develop and support health care delivery that optimizes stewardship of resources.


• Treat every patient, colleague, and associate of Wheaton Franciscan Healthcare with respect, dignity, and compassion.
• Actively support organizational and group goals.
• Actively listen, share ideas, and communicate.
• Encourage patient and family involvement in care and treatment decisions.
• Honor diversity, culture, and privacy.

• Demonstrate the highest level of ethical and professional conduct.
• Engage in open and honest written and verbal communication.
• Reflect on mission, vision, and values when making decisions.
• Proactively identify and collaboratively resolve issues.
• Maintain a high level of personal accountability.

• Champion innovative and continuous improvement.
• Participate in organizational development and strategic planning.
• Show support for the communities we serve.
• Encourage and contribute to organizational leadership.
• Accept and offer respectful feedback that promotes personal development.
• Participate in clinical and professional development opportunities.

• Commit to maintain optimal patient access.
• Encourage a team approach to patient care and satisfaction.
• Participate in clinical, operational, and service excellence initiatives.
• Utilize resources, processes, environments, and when available, evidence-based guidelines to achieve quality
care and service excellence.

• Support strategic and financial objectives.
• Be responsible for successful and timely completion of work.
• Maintain health, safety, and security in the workplace.
• Support health care delivery that optimizes stewardship of resources.


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