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4 Perspectives on Physician Alignment

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Healthcare reform and the Patient Protection and Affordable Care Act have affected nearly all aspects of the industry, and physician alignment is no exception.

That was the topic of discussion at a panel at Becker's Hospital Review 4th Annual Meeting in Chicago on May 9 featuring Daniel DeBehnke, MD, MBA, interim CEO of Medical College Physicians at the Medical College of Wisconsin in Milwaukee; Richard Ferrans, MD, ScM, system vice president of clinical and accountable care for Presence Health in Chicago; Craig Rhyne, MD, CMO of Covenant Health in Lubbock, Texas; and Michael Piver, director of strategic integration for surgical services at Carrollton, Ga.-based Tanner Health System. Michael Glick, senior manager at Blue & Co., moderated the discussion.

Many hospitals and health systems have been changing their physician alignment strategies to attempt to provide coordinated, accountable care. The change in strategy requires a change in hospital and health system's attitudes toward physicians, but physicians' attitude toward hospitals must change as well in order to achieve success.

The panel participants, though all based in different regions of the country, are facing the same issues with their physician alignment strategies. Dr. Rhyne talked about "cowboy" physicians in Texas who want to remain independent. "They don't want anyone telling them what to do," he said. Dr. Ferrans in Chicago also referred to cowboy physicians, but of the urban variety. He said he has taken a "no bull" approach to physician relations with his urban cowboys. "It seems to be very effective," he said. "Have frank conversations" with physicians, he urged, about how physicians and health systems need to work together to survive in the future.

Another issue to overcome, besides drawing physicians into new alignment models, is getting the current medical staff and aligned physicians on board with an accountable care alignment strategy. "We use data to prove points," said Mr. Piver. At Tanner Health System, system leadership holds regular meetings with its physicians to show strong data to prove the changes are working. "We're trying to be very transparent."

Dr. DeBehnke has found that the majority of physicians at the Medical College of Wisconsin are going along with the change and believes that the other roughly 20 percent will come around because of their peers' support of accountable care.

Dr. Ferrans agreed about the naysayers: "ignore them," he said, because soon the believers will outnumber the naysayers and treat the negative physicians like a "crazy uncle."

As the panel showed, physicians and healthcare executives across the country are dealing with the same alignment changes and challenges, but it is clear the two groups must work together in order to achieve future success.

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