Recently, I was talking to the vice president of medical affairs at a major Midwest hospital system, and the conversation turned to physician employment. A physician himself, he reflected on the shift we've seen over the past dozen or so years on the subject of physician employment.
About a decade ago, hospitals were busily divesting themselves of hastily-acquired physician practices that weren't panning out as the hospitals had planned. What they found was that they were the (sometimes willing) victims of a bubble in physician practice valuation. Not only that, but they found that once they had acquired the practices, they had neither the expertise nor the systems to run them efficiently or to ensure the productivity of physicians who had become employees.
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"A big part of our future is in alignment and integration," he said. "Now, cardiologists, for one example, are knocking on our door and practically begging for employment. That allows us to be innovative in employing right groups who are really interested in working with systems and being measured for quality and productivity."
Yes, hospitals are once again interested in acquiring physician practices, mainly because it offers them a way to ensure accountability, quality, and productivity in an era where excellent performance on those measures is financially rewarded. And this desire for employment stretches far beyond cardiology. But the work is really in the integration, not the art of the deal.