1. To increase patient access. “Patient access is a key reason why general internists and family physicians are desirable for hospitals,” Ms. Barber says. “Primary care doctors improve inpatient and outpatient volume and referrals to specialists.” Because the ED is a key conduit for admissions, emergency medicine physicians are also in demand. Hospitals also seek out internists because they are the primary source for hospitalists. Hospitalists can relieve primary care doctors of inpatient responsibilities, allowing them to be more productive in their practice. This relieves the growing demand for generalists.
2. To compete for revenues. Hospitals have been building up service lines such as orthopedics, cardiac health, urology and gastroenterology. “These are drivers of revenue for hospitals,” Ms. Barber says. “The key here is high volume, high reimbursement procedures, such as orthopedics, that are also expanding due to aging population.” Many patients of these specialties are admitted to the hospital. On the other hand, “some specialties aren’t attractive to hospitals from a revenue perspective because the procedures utilize significant hospital resources but don’t generate a comparable revenue,” she says. ENT physicians do not generally have many cases in the hospital. Therefore, reimbursements are less likely to cover the costs. Pathologists endocrinologists and nephrologists and are also not as high a revenue source, she says.
3. To be a center of excellence. The chief centers of excellence are for cardiovascular care and oncology. “It is very important for the specialty center to have many highly specialized physicians as possible,” Ms. Barber says. At a cancer center, for example, they would want doctors that sub-specialize in only certain types of cancer, but the center would also need radiologists, surgeons and other physicians. Most community hospitals, on the other hand, would not be able to support such a center, so it would have less demand for specialists like oncologists. “They would then not have a need for many oncologists, because patients would be referred to the specialty center,” she says. Instead, these hospitals may look for a different niche of specialists.
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