Wednesday, April 15, 2015

The Secret to Physician Engagement? It's Not Better Pay

Lena J. Weiner, for HealthLeaders Media , March 7, 2014

It takes more than money for hospitals and health systems to motivate and retain employed physicians, says a senior executive at Catholic Health Initiatives.

More doctors are leaving private practice for positions in hospitals and health systems—and they report the new model of doing business looks promising. The benefits of being of an employed physician are anticipated to include "improved communication, greater transparency, better physician job satisfaction and a more patient-centered focus," says a survey by the American College of Physician Executives.
"It's the reality, and healthcare needs to accept this reality," said Peter B. Angood, MD, CEO of the ACPE. "Everything is moving in the direction where physicians want to be employees…I'm not a zealot of it, but it's a phenomenon that's happening, and we need to embrace it."

20-question survey sent to 10,000 members of the ACPE was completed by 617 respondents. Of those, 59 percent said that at least 50 percent of the physicians in their healthcare organization were directly employed—and 18 percent of the respondents said all physicians in their organization were directly employed.
Not Like the 1990sThis isn't the first time the healthcare industry has trended away from private practice and toward hospital-employed physicians. In the early 1990's, physicians began flocking to healthcare organizations as a part of the Managed Care trend, which later fizzled out amidst a consumer backlash citing decreased quality of care and allegations of withholding necessary medical procedures to cut costs.

Angood says the current push toward employed physicians is different. "It seems both the physician workforce as well as healthcare systems are committed to not having the same issues pop up as did in the early 1990's," he said, adding that many of this generation's physicians are happy to take advantage of focusing on treating patients and to take advantage of the improved work-life balance that working for a hospital or other organization offers.
"It's getting harder and harder to manage your own practice. Smaller groups don't have the capital, and banks don't want to lend money for these things," T. Clifford Deveny, MD, Senior Vice President, Physician Services and Clinical Integration at Catholic Health Initiatives, said.
In addition to freeing themselves of duties related to finances, marketing, and other administrative physicians frequently find benefits packages in large organizations superior to anything they could obtain in private practice, with traditional benefits such as paid time off, competitive health insurance and retirement savings programs, and in some instances, "boutique" benefits such pet health insurance or concierge services.
"Traditionally, a physician is trained to be an independent thinker and do what they think is best, but integrated systems are there for the benefit of the patient, not the practitioner," Deveny said. "I've always been cautious to say whether employing physicians will improve their jobs."
Deveny also expressed concerns about physicians feeling like they were simply a cog in a machine, rather than a doctor actually treating patients. "When the IT guy or finance person doesn't meet your needs, you get frustrated," he commented. 
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