Inhibitors to hospital-physician alignment, respondents said, are related to practice autonomy/governance (52%), physicians’ perceived value of the relationship (51%), and local
“These responses, to me, are less about autonomy and more about truly believing the physician will be engaged. Physicians think, if they go internal, is the pattern such that they’re really not included in governance? That’s the worry, and some who were employed before really worry about this.”
Another big inhibitor to physician alignment seems to be the shortage of physicians in key specialties, a problem that is not easily addressed by individual institutions, no matter their size and scale. Most survey respondents (65%) rated such shortages a 4 or 5 on a scale of 1–5, where 5 represents a very serious threat to their hospital-physician alignment strategy.
Another issue that confounds hospital and health system leaders surrounds hospital and physician participation in collaborative care models, such as accountable care organizations and the patient-centered medical home.
Even though 71% of the organizations surveyed said they would soon participate in a collaborative care model in which the physician might not make all the decisions surrounding care of their patients, only 9% say their physicians support those moves, while 62% report their physicians are mixed in their support levels.