Doctor-Hiring Rush is On

Karen Minich-Pourshadi, for HealthLeaders Media , April 2, 2013

Browne says the difficulty in creating alignment between physicians and hospitals often rests with the lack of timely and accurate clinical data, especially if you are going to create risk-based employment agreements.

"Physicians want to know, like anyone else, how they are measured and how they are doing if they are going to take on any risk. They need to be clear on how they will be measured and tracked, so you have to choose metrics that are reasonably easy to reproduce—and you don't want 15 metrics, you want two to four," he says. "To encourage that alignment, there's got to be a lot of conversations on the front end about how we can agree to hold each other accountable on quality, and you need to put it in the contract."

Also, Browne says the contract needs to be relatively simple and easily understandable, and should include both achievable and stretch goals. "We're openly sharing the metrics we're tracking with our physicians so we can learn from each other, but it's a work in process with population health," says Browne.
Ultimately, when it comes to deciding whether to employ a physician, Browne and Manas agree it shouldn't be rushed, nor should it be done to keep pace with other hospitals in the marketplace.

"When organizations move too quickly and believe the physicians are in agreement with their goals and that there will be an alignment, but then realize after the fact that there wasn't agreement, it will cause problems," says Manas. "There's a lot of pressure within the marketplace to employ, and organizations sometimes make decisions based on the frenzy in the marketplace and not based on their due

To be successful, Browne says, employment has to fit not only the physician, but also the healthcare organization. "Some systems employ the majority of their doctors, and for other systems that model doesn't fit into their strategy; for us it's not the only option," says Browne. "Still, physician employment needs to remain in the toolbox as an option, and if and when the timing is right for an organization, then it can be the right move."

Reprint HLR0313-8

This article appears in the March 2013 issue of HealthLeaders magazine.

Karen Minich-Pourshadi is a Senior Editor with HealthLeaders Media.
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4 comments on "Doctor-Hiring Rush is On"

Dr Bob (4/28/2013 at 7:49 PM)
"healthcare reform as the time that not only made improvements in the quality of patient care " Karen, with that one statement in the opening sentence I realized you are clueless re medical care, the determinants of health, and the intent of the "Affordable Care Act" Dr Bob

Paul Schwartz (4/3/2013 at 9:29 PM)
The current trend in employment opportunity for physicians, while unarguable, is certainly both disappointing, and worrisome. The pure employment model of healthcare is not what the average U.S citizen desires, or expects. Think Canada, think V.A. hospital, think Kaiser. Low production models that save money primarily by limiting access to services. Certainly some organizations such as the Mayo Clinic, and Cleveland Clinic have been very successful with an employment model and provide superb medical care, but these are definitely in the minority, and, are at their root, superb examples of private practice medicine expanded to offer large arrays of service, rather than a hospital organization seeking to capture market share. We have resisted this change, as a medium sized multispecialty group practice, but are certainly worried by the seeming ignorance of the federal government and it's inability to recognize and treat the real problems that exist in today's health care in the United States. I hope that at some point both the government, and the populace in general will begin to recognize the worth in having hard working, independent physicians, who care most for the health of their patients, and are willing to devote time and money towards research and exemplary health care, rather than encouraging an entire army of complacent, unmotivated physicians simply collecting a salary from the hospital behemoth that is controlling all of medicine in it's own best interest.

Greg Mercer, MSN (4/2/2013 at 7:18 PM)
Physicians had their time of power and prestige, and they gave it away for all the money thrown their way by all the insurance and Pharma conflicts of interest they have become quite addicted to as a group. The loss of credibility and presitige that has resulted has, at long last, beugn to seriously erode physician power, autonomy, and incomes. You reap what you sow, and power lasts only as long as you maintain it: take it for granted for an few generations and poof! It's gone.




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