3 Thoughts from Healthcare Leaders on Hospital-Physician Relationships

Learn how four healthcare leaders view hospital-physician arrangements.

During a panel discussion at the Becker's Hospital Review Annual CEO Strategy Roundtable on Nov. 14, Union Associated Physicians Clinic CEO Patrick Board; Ambulatory Surgical Centers of America Principal and Founder Brent Lambert, MD, FACS; HealthCare Appraisers Partner Scott Safriet, MBA, CVA; and HC Wisdom President Brian Silverstein, MD, discussed physician alignment strategies, co-management joint ventures, employment and more.

1. Physician employment rates aren't high across the board. Although the rate of physician employment by hospitals may be high on average lately, it varies significantly from market to market, Dr. Silverstein said.

"In some markets there's very little employment," he said. "In others, there's a lot. I'm not sure the average is really the key metric."

Dr. Lambert echoed that sentiment, saying his business sees drastically different situations depending on the market when it ventures into various geographic regions looking to recruit physicians.

"We come into some communities where there are no surgeons to sign up," he said. "They're all employed by the hospitals. And then we come into some areas where almost none are signed up. There's a lot of variation there."

2. Don't be creative with physician alignment for the sake of being creative. Mr. Safriet said he's observed hospitals and health systems making physician crafting physician employment arrangements in increasingly creative and complicated ways.

He doesn't view that as a positive development. An employment model that takes pages and pages to explain and includes formulas within the compensation formula could lead to problems with documentation, among other issues, he said.

"Being creative for the sake of being creative is really dangerous," he said. "I think in many ways hospitals need to get back to basics."

3. The physician shortage could be fixed by redefining roles and innovative care. The Association of American Medical Colleges has predicted a 150,000 physician shortage by 2025. However, the panelists said this isn't necessarily reason to panic.

Mr. Board said redefining physician roles in terms of which tasks they perform and which patients they see has helped his clinic tremendously so far.

"We're looking for that nurse practitioner role to really expand and have the physician role defined very, very differently," he said.

Dr. Silverstein agreed redefining physician roles is one remedy to the issues surrounding the impending shortage. He also said telemedicine will mitigate the problem by allowing physicians to reach broader patient populations virtually.

Overall, considering telemedicine and other innovations, it's difficult to say what the true extent of the shortage will be, he said.

"The market will work itself out," Dr. Silverstein said. "It's hard to put a number out there."

More Articles on Hospital-Physician Issues:
4 Tips to Ensure Compliance in Hospital-Physician Financial Relationships
Healthcare Reform: Where Do ASCs & Group Practices Stand?
20 States With the Most, Least Physicians by Population

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