Beyond Buy-In: Building Physician Readiness for Change in Today's Health Care Environment

Physician readiness for change has become a critical factor in successful transformation efforts.

Explore how your medical group can proactively assess and strengthen this readiness in the early stages of any change initiatives.

 By Jackie Bassett, Principal, Lotis Blue Consulting in partnership with SullivanCotter

Medical groups are navigating extraordinary complexity. Margin pressure, workforce shortages, rising patient acuity, evolving payment models, and the rapid integration of digital and AI technologies have reshaped what it takes to lead a high-performing physician organization. In response, many medical groups are reevaluating their leadership structures, clarifying roles, and updating their compensation frameworks. But even the most compelling strategy will fall short if physicians are not ready for the change.

Research shows that physician engagement and physician change readiness are among the strongest predictors of whether transformation efforts succeed in medical groups and other physician organizations. In today’s environment—marked by eroded trust, accumulated change fatigue, and expanding expectations for physician leadership—physician readiness for change cannot be assumed. It must be deliberately understood and cultivated. This article examines the factors that contribute to physician change readiness, why it is emerging as a strategic differentiator for medical groups, and how organizations can identify and mitigate the risks that frequently derail transformation efforts.

To illustrate these concepts, we reference a recent medical group initiative aimed at clarifying the roles, expectations, and compensation of Medical Directors. Although the initiative carried financial implications, its core purpose was to ensure that physician leaders were working at the top of their training and that leadership roles reflected meaningful scope and responsibility. Because the redesign impacted long-standing roles, identity, and leadership expectations, the work was inherently personal, making physician readiness for change essential to a thoughtful and successful transition.

The Strategic Context: Why Physician Change Readiness and Change Management in Healthcare Matter More Than Ever

Medical groups operate at a critical intersection of mission, margin, and clinical performance. They are expected to deliver access, quality, experience, and operational efficiency—often while navigating staffing shortages, reimbursement pressure, technology disruption, and rising expectations for physician leadership. In the past year alone, many medical groups have had to manage:

• Enterprise cost restructuring
• Operating model redesign
• Care team delivery redesign
• Reimbursement changes
• Compensation model changes
• Quality and access transformation
• Digital and AI implementation
• Site consolidation and service realignment
• Leadership transitions
• Intensifying performance expectations

In this environment, physicians are not only absorbing more change, they are being asked to lead it as well. As one physician leader reflected:

“It feels like we’re being asked to build the plane while flying it, and someone keeps changing the destination.”

The success of any transformation effort ultimately hinges on physician buy-in; whether they understand the change, believe in its intent, and feel equipped to adapt to new expectations.

The Data: Why Physician Readiness for Change Matters

Decades of research reinforce the importance of change readiness in health care transformation. McKinsey estimates that nearly 70% of major transformation efforts in health care fail to achieve their intended outcomes2, most often due to cultural barriers, insufficient leadership alignment, and inadequate change readiness, not because of flaws in the strategy itself. Physician leadership is especially critical. In a national survey by the American College of Healthcare Executives (ACHE), 60% of health care executives identified physician buy-in as the single most important determinant of whether a major change effort ultimately succeeds. Taken together, these findings highlight a core truth: physician readiness for change is not a soft concept; it is a measurable, predictive factor that determines whether major initiatives take hold.

Why Physicians Experience Change Differently

Physicians are not inherently resistant to change—if anything, their work requires constant adaptation. But the way physicians process, evaluate, and adopt change differs in important ways:

• Autonomy and identity: Physicians are trained to make independent, evidence-based decisions. Changes that alter their autonomy, role, or compensation can be experienced as deeply personal.
• Peer-driven influence: Physicians tend to be most influenced by colleagues they trust, not by broad organizational messaging.
• Evidence orientation—and skepticism: Physicians want data-backed rationale, yet many carry skepticism shaped by past initiatives that were rolled out quickly or communicated inconsistently.
• Cognitive load and burnout: Ongoing staffing shortages, documentation burden, and workflow pressure make even well-intentioned changes feel like additional weight.
• Cultural norms: Professional cultures that emphasize collegiality and clinical autonomy can conflict with system-driven accountability, standardization, and governance.

These dynamics help explain why traditional, top-down change management often falls short in medical groups. Supporting physician readiness for change requires an approach grounded in trust, transparency, and shared leadership.

Understanding Physician Readiness for Change: A Predictive Lens for Successful Change Adoption

When significant change is on the horizon—especially change affecting leadership roles, compensation structures, or accountability expectations—organizations often move through the entire design phase and only begin thinking about change management once implementation planning is underway. But effective change management should begin much earlier. A change readiness assessment conducted during the design phase, well before implementation planning begins, helps leaders understand how physicians are likely to experience the change and what they will need to adopt it successfully. This early insight prevents unvalidated assumptions from becoming embedded in downstream plans, timelines, and messaging. A structured change readiness assessment conducted early—while the medical group is still defining the change, shaping the future-state model, and making key design decisions—helps leaders understand the realities that will influence physician adoption before implementation plans are locked in. Change readiness assessments enable medical groups to:

• Identify risks that could slow adoption or fuel resistance
• Understand lived experience, including workload, culture, and competing demands
• Tailor communication and engagement strategies while designs remain flexible
• Support leaders intentionally, with attention to alignment, capability, and sponsorship
• Sequence the rollout realistically, reflecting operational and cultural dynamics

This shifts the mindset from “How do we implement?” to “What will it realistically take to adopt this?”

A Structured Lens for Understanding Change Readiness

A comprehensive change readiness assessment examines the key dimensions that influence physician adoption of change, such as the clarity of the case for change, leadership alignment, sponsorship strength, cultural norms, operational preparedness, workforce capability, and stakeholder sentiment.

 

Different medical groups may use different frameworks, but the objective is consistent: identify where momentum exists, where skepticism is likely, and what barriers must be addressed to support physician adoption of the change.

What Physician Readiness for Change Reveals in Practice

During a recent medical group initiative to clarify leadership roles and redesign compensation, several change readiness themes emerged:

• Unclear or mistrusted rationale: Physicians questioned whether the redesign was strategic or primarily financially driven, influenced by past initiatives where the stated purpose did not fully align with the underlying intent.
• Fragmented leadership alignment: While executives were aligned, downstream leaders held varying interpretations.
• Accumulated fatigue: Physicians described a long series of changes, often experienced as additive rather than supportive.
• Limited sponsorship: Advocacy concentrated among a small number of leaders; influential physicians were not yet engaged.
• Operational uncertainty: Practical questions around timelines, transitions, HR processes, and impact on physicians generated anxiety.
• Capability gaps: Medical group leaders expressed concern about whether physicians would have the skill sets needed for the redesigned leadership roles; identified gaps included change leadership, financial acumen, and performance management.
• Organizational friction: A long-standing culture of autonomy at the organizational leadership level often slowed approvals and progress. This had complicated previous efforts to strengthen consistency and accountability.

These findings did not indicate that the change should slow; they clarified what would be required to implement it successfully. As one physician put it: “We’re not opposed to change. What’s hard is when it feels like the rationale is unclear or the expectations shift without explanation.” Change readiness work gives leaders a way to see and address these dynamics before implementation planning begins.

Turning Change Readiness Findings into Mitigation Strategies

A change readiness assessment is most valuable when it informs a targeted, risk-based plan of action. The table below illustrates how insights into physician readiness for change can be translated into targeted mitigation strategies.

 

From Change Readiness Insights to Targeted Actions

 

Linking Change Readiness to an Effective Healthcare Change Management Approach

Once risks are understood, leaders must decide how to guide physicians through the transition. A useful way to structure this thinking is through three phases—Align, Equip, and Sustain—each of which can be tailored to the specific needs of physicians.

1. Align: Establishing clarity, unity, and trust

Physicians engage more readily when the purpose of the change is explicit, when expectations are transparent, and when clinical and administrative leaders speak with a unified voice. For change leaders, this means:

• Co-creating the case for change with physicians
• Ensuring alignment across system, hospital, and departmental leadership
• Communicating early about what is changing, and what is not
• Being explicit about how physicians can provide input and when decisions are fixed

This phase addresses change readiness gaps related to trust, clarity, and alignment—critical drivers of physician adoption.

2. Equip: Building physician capability and confidence to lead through change

Leadership expectations are evolving. Physicians are increasingly asked to manage teams, lead peers, make data-driven decisions, and navigate performance expectations. Preparing physicians to succeed requires:

• Leadership development tailored specifically to physician roles
• Guidance for high-stakes conversations and peer accountability
• Clear decision rights and governance structures
• Practical tools that reduce cognitive load rather than add to it

This phase addresses change readiness gaps related to capability, sponsorship, and new ways of working.

3. Sustain: Reinforcing new expectations through culture, systems, and follow-through

Change doesn’t stick because a plan was launched; it sticks because it is reinforced. Sustaining physician adoption involves:

• Monitoring behavior change, not just implementation milestones
• Highlighting early wins to demonstrate progress
• Clarifying how the change will be embedded in performance management and incentives
• Continuing to listen and adjust as physicians navigate the transition

This phase addresses change readiness gaps related to cultural norms, reinforcement, and operational consistency.

 

A Framework for Successful Change: Align, Equip, and Sustain

 

Successful Change Begins with Ensuring Physician Readiness for Change

Health care is entering a new era—one characterized by accelerated transformation, heightened expectations, greater need for accountability, and the increasing centrality of physician leadership. In this environment, physician readiness for change is not simply a step in the process. It is the foundation for whether a change will succeed. A strategy can be analytically sound and operationally precise, but it becomes real only when physicians understand it, trust its intent, and feel equipped to lead through it. Taking time early to understand physician change readiness, openly, honestly, and without assumptions, enables a different kind of change:

• One grounded in partnership rather than compliance
• One focused on transparency rather than ambiguity
• One shaped through dialogue rather than directives
• One that respects the realities of physicians and responds to what they need to navigate transition successfully

As a physician leader shared during a recent transformation:

“I can adapt to almost anything. What I need is to feel respected in the process.”

Ultimately, that is the promise of investing in physician readiness for change. It builds an environment where physicians can lead confidently, where patients benefit from more aligned teams, and where organizations strengthen their resilience, not just for this change, but for the next one and the one after that. When medical groups commit to understanding physician readiness early and deeply, they are not just preparing for a single initiative. They are building their long-term capacity to change well—again and again.