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A fresh look at physician employment by hospitals



“The Doctor,” by Luke Fildes 

With health-insurance companies and hospital systems getting fewer and bigger, more physicians are seeking to work in hospitals, which have more price-power than  do  physician groups.

Paul Keckley, of Navigant Healthcare, takes a fresh look at physician employment by hospitals. He poses some big questions and at least implies some answers.

“Here’s the challenge for hospitals: employing physicians is not a slam dunk, even if the market is benign about shared risk arrangements with payers. Physicians want clinical autonomy whether employed or not. Physicians want the technologies and tools that are required to ply their trade and they expect them to help, not hinder their work. Physicians want to be heard on matters of consequence to the entire organization, not just clinical issues de jour. Physicians want to be  ‘in the room,’not outside looking in. Physicians want to be compensated for their experience and aptitude, not just their production. And they want to be aligned with a winning organization that’s recognized for quality and well-positioned long term.”

“In tandem with the Healthcare Financial Management Association, we gathered impressions from the administrators of 44 hospital-sponsored group practices to see how their marriage with the hospital is working. They’re losing sleep over three concerns:

Operations: “We worry about how to operate the group efficiently as payments shift from volume to value, margins shrink, and costs for information technology and labor increase. It’s a tough job, and it’s a different job than running the hospital.”

Compensation: “We worry about how to compensate doctors as the change from production to performance accelerates. Doctors like to ‘eat what they kill’ and they expect to get paid well. Something’s gotta give.”

Recruitment: “We worry about how we will recruit new physicians to join the group and sustain its growth.”    




CMO’s and CFO’s must get friendlier


An article in FierceHealthcare discusses how the changing healthcare industry “means that chief financial officers and chief medical officers must put aside historical friction in favor of collaboration.”

”The roles and responsibilities of the two positions made working together difficult in the past,” John Byrnes, M.D., a board member of the Healthcare Financial Management Association and founder of the Byrnes Medical Group, told the news service.

“CMOs generally don’t have a business background, so they speak a different language than the CFO and vice-versa,” noted Dr. Byrnes, the former CMO of SCL Health, in Denver.

The disconnect includes building design.   “You don’t really find finance offices close to clinical care, patient care areas,” he said.

But with the Affordable Care Act,  Dr. Byrnes says, “CFOs are starting to realize that any improvement in care that the chief medical officer can drive through the organization also has significant financial benefits because more often than not it will remove some of the unnecessary costs in patient care out of the organization.”

Finding common ground benefits both the clinical and the financial sectors because it bridges the goals of lower costs and improved patient outcomes.



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