Council Connection: Physicians as Co-managers

A lot of it is relationships. They have to be docs you trust and, in essence, people you want to be in business with. You just can’t say ‘I am going to create this comanagement program. I can’t stand the docs but I am going to do it anyway.’ That is just asking for trouble. It truly has to be almost a joint venture. The service line has to be separated out. The ones that I have seen that work are a true comanagement. There is a board, and it’s not just a medical director but a lot of docs involved.

It can work with an employed model. It would be more on the incentive side. The advantage is there are some doctors who don’t want to be employed, and this is a way, especially with the specialties, to allow them to be engaged with the organization without being employed.

When everybody is working toward the same objective, everybody—physician and otherwise—is going to be cognizant of costs. If you have a management team made up of physicians and administrators, the doctors would say, for example, one of the reasons this particular service line costs so much is that the operating room turnaround is 28 minutes, and down the street at the ambulatory surgery center the turnaround is 15 minutes. The reason is that we as doctors manage it and it affects our revenues.