Inside Your Head

Rick Johnson, for HealthLeaders News , August 16, 2007

As always, a hospital's financial success is determined by physician referral and admission patterns, but today there are numerous models for hospital-physician partnerships, largely because many physicians are in a position to take their business out of the hospital setting. A HealthLeaders magazine article, titled Dr. Partner, had a quote about the evolving hospital-physician relationship from Richard Sheff, MD, chairman and executive director of The Greeley Company:

"CEOs are basically being put in a position where a physician comes in and says, 'I want to take my business out.' And the CEO is in a position where they have to ask, 'Can I have half of it?'"

Administrators want inside the physician's head more than ever before. Moreover, they need to get key doctors engaged to help grow profitable service lines and keep patients coming through the doors.

A report came out yesterday by Press Ganey called Physician Perspectives on American Hospitals. The report is based on a 2006 survey of 21,000 physicians at 224 hospitals across the nation.

Press Ganey says these are physicians' top five priorities:
1. Response of hospital administration
2. Patient care made easier
3. Administration deals with changes
4. Confidence in hospital administration
5. Communication with hospital administration

Four of the top five priorities deal directly with the administration-physician relationship. Joel V. Brill, MD, chief medical officer for Predictive Health, LLC, is not too surprised by the results.

"When physicians perceive a breach in communication, or that the hospital is not responsive to their needs, it is not surprising that they seek to develop imaging centers, specialty hospitals, and ambulatory surgical centers in the desire to provide efficient and cost-effective care in a patient-focused environment," says Brill.

The report also analyzed physician satisfaction by specialty and found surgeons to be among the least satisfied physicians. This should give any hospital administrator reason to sweat, considering that surgeons in general are significant contributors to revenue.

"Hospital administrators should study this report in depth and review which specialties are most and least satisfied," says Brill. "If they fail to heed the warnings about the need to communicate, and to be responsive to physician needs and ideas, they face the threat of a dysfunctional relationship with their medical staff and the provision of healthcare, which would lead to a lose-lose scenario."

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

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