Top 4 Challenges of Moving Self-Employed Physicians to Hospital Employment

In the Becker's Hospital Review 5th Annual Meeting in Chicago, Ronald Riner, MD, president and CEO of The Riner Group, discussed the challenges of integrating previously self-employed physicians into the hospital setting as well as how alignment between hospitals and physicians can be created.

According to Mr. Riner, employment dynamics are changing and more physicians are moving into the employed setting. There are two main groups of physicians coming into the hospital employment setting — younger physicians, just out of medical school who don't want to deal with the business side of medicine and older physicians, who don't have an exit strategy from their practices and are using hospital employment as their exit strategy.

Some of the biggest challenges of bringing self-employed physicians into hospital employment, according to Mr. Riner, are:

1. The employer-employee relationship is poorly understood, especially when hospitals are dealing with physicians who have thus far been in charge and are now expected to defer to hospital administration.

2. There is often an issue of accountability and transparency — physicians are often not told clearly what is expected of them.

3. Physicians are worried about their ability to innovate under a stifling bureaucracy.

4. Medicine is inherently a long-term business, and the death knell of a new hospital-physician relationship is CEO turnover, which has been on the rise in the last few years.

So how can hospitals create alignment and develop loyalty?

"Money is not the answer," said Dr. Riner. "Providers are looking for meaningful and purposeful work. In fact, for the most part, people get into healthcare because it is purposeful. A majority of physicians are still primarily interested in providing quality care."

Hospital leadership needs to attuned to the fact that for self-employed physicians entering hospital employment, it is a different world and one that they are hesitant about. They need to understand the nuances of that change and create alignment strategies around that understanding. They must talk to physicians in terms of the purposeful work that they do, rather than devoting the conversation to finances and pay structures.

"Clinical talent is the biggest asset that hospital businesses have," said Dr. Riner. "When looking to make investments, hospitals must not forget about investing in this talent."

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