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Doctor-Hiring Rush is On

Karen Minich-Pourshadi, for HealthLeaders Media, April 2, 2013

Newly minted physicians are displaying a generational shift in their overall work philosophy. They want to be employed following residency not only to focus more intently on patient care but also to give their lives stability. Newer physicians don't have the desire to continually work 80-hour weeks and instead strive for a work-life balance, says Britt Berrett, PhD, president of Texas Health Presbyterian Hospital Dallas, an 898-licensed-bed acute-care hospital with more than 800 employed physicians and physician extenders within the Texas Health Resources healthcare system.

Recognizing the mind-set of the generation you're hiring, Berrett says, is an ingredient that shouldn't be overlooked. Moreover, while hospitals may wish to hire a physician to fill a service line gap, a new physician won't come with an established patient base, which can slow referral revenue and productivity.

"The new generation of physician has significantly different expectations than physicians of the past," Berrett says. "These physicians have a tremendous desire for work-life balance, and it seems the lion's share of these new physicians prefer the stability of being part of a bigger system."

More experienced and established physicians also bring their own pros and cons. The changes in healthcare are making the small practice setting more administrative and disenfranchising these doctors from maintaining their own practices. It's now more expensive and even more time-consuming to operate a practice. Employing these established doctors means a hospital must create a contract that provides financial security but also allows for autonomy. And a greater challenge lies in guiding the physician toward meeting the organization's goals.

"Some of these physicians want to slow down and have some more personal time, but what we find is more often the physicians who have been in practice for a while want to concentrate on the complexities of medicine and don't want to deal with the changes to the revenue cycle and the billing. Gone are the days when the physician's spouse could do all the billing," notes Berrett. "These folks are coming to us to provide the backbone and infrastructure they need to keep their focus on practicing medicine. They want to use their MD and not have to get an MBA to do it."

Employment versus joint venture

Berrett says that employment, as opposed to a joint venture, offers the physician and the practice other benefits such as better pricing on an IT platform and more sophisticated revenue cycle and collections.

In addition, the strength of employment comes from having a contractual tie to an individual, whereas a joint venture tends to be with an entity that has multiple partners. "Sometimes an employment agreement with a singular physician can be less complicated and move forward more easily than trying to create a joint venture," adds Julie Manas, president and CEO of Sacred Heart Hospital in Eau Claire, Wis., and division president and CEO of the Western Wisconsin division of Hospital Sisters Health System. The 344-licensed bed acute care Sacred Heart is an affiliate of the Hospital Sisters Health System.

Sacred Heart employs just 20 physicians and adds to those numbers judiciously based on market factors, Manas explains. Sacred Heart is situated near the Marshfield and Mayo clinics as well as the University of Wisconsin-Eau Claire medical school and the OakLeaf Surgical Hospital and Medical Network, a 200 physician-owned organization.

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4 comments on "Doctor-Hiring Rush is On"


Dr Bob (4/28/2013 at 7:49 PM)
"healthcare reform as the time that not only made improvements in the quality of patient care " Karen, with that one statement in the opening sentence I realized you are clueless re medical care, the determinants of health, and the intent of the "Affordable Care Act" Dr Bob

Paul Schwartz (4/3/2013 at 9:29 PM)
The current trend in employment opportunity for physicians, while unarguable, is certainly both disappointing, and worrisome. The pure employment model of healthcare is not what the average U.S citizen desires, or expects. Think Canada, think V.A. hospital, think Kaiser. Low production models that save money primarily by limiting access to services. Certainly some organizations such as the Mayo Clinic, and Cleveland Clinic have been very successful with an employment model and provide superb medical care, but these are definitely in the minority, and, are at their root, superb examples of private practice medicine expanded to offer large arrays of service, rather than a hospital organization seeking to capture market share. We have resisted this change, as a medium sized multispecialty group practice, but are certainly worried by the seeming ignorance of the federal government and it's inability to recognize and treat the real problems that exist in today's health care in the United States. I hope that at some point both the government, and the populace in general will begin to recognize the worth in having hard working, independent physicians, who care most for the health of their patients, and are willing to devote time and money towards research and exemplary health care, rather than encouraging an entire army of complacent, unmotivated physicians simply collecting a salary from the hospital behemoth that is controlling all of medicine in it's own best interest.

Greg Mercer, MSN (4/2/2013 at 7:18 PM)
Physicians had their time of power and prestige, and they gave it away for all the money thrown their way by all the insurance and Pharma conflicts of interest they have become quite addicted to as a group. The loss of credibility and presitige that has resulted has, at long last, beugn to seriously erode physician power, autonomy, and incomes. You reap what you sow, and power lasts only as long as you maintain it: take it for granted for an few generations and poof! It's gone.