Doctor Paycheck

Rick Johnson, Senior Editor , June 28, 2007

Consider all the ways hospitals nowadays are attempting to fortify physician relations. With a looming shortage of primary care providers, hospital executives have to come up with strategies to maintain referrals and ensure care in their communities. Executives frequently tell me about their plans to increase the number of employed physicians. In fact, my colleague Philip Betbeze wrote a fine cover story called Keep 'Em Close in this month's issue of HealthLeaders magazine. This story shows how some hospitals are aligning with physicians through the clinical integration model of healthcare.

If they're not hiring physicians outright, hospitals are coming up with new ways to keep docs connected to their facility. Some strategies are ingenious, like Kadlec Medical Center's physician portal that provides referring doctors with digital images and patient records. Letting primary care doctors access patient information remotely--combined with a hospitalist program--is helping Kadlec expand the distance of its referral network.

And, of course, after nearly a decade, the hospitalists ranks continue to grow. As frequent contributor Richard L. Reece, MD, points out in a recent column, Six Innovations to Increase Productivity, "Because hospitalists are on the spot to deal with problems that arise in hospitals--and because hospitalists are well trained in addressing urgent and clinical care--patient safety improves, complications decrease, and hospital stays shorten. And busy primary care physicians admitting to the hospital . are grateful because they have more free time for themselves and their families."

Chris Nussbaum, MD, worked for 10 years as a solo-practice internist, shuttling between his office and visiting patients in hospitals. He says that given the reduction in reimbursement and the reduction in quality of life, he suspects primary care will continue to suffer. Nussbaum eventually founded an independent hospitalist group in Tampa Bay, called Synergy Medical Group, P.A. "The model where the internist rushes about to check on patients in the hospital and keep appointments scheduled at his office is not efficient," he says. "There isn't a whole lot of attraction to that unless you have a particularly altruistic person. Most physicians are, but we want to make a living, too."

Rick Johnson is a senior editor with HealthLeaders Media. He can be reached at

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