Physicians are making more requests for full-time employment, with more being granted and considered by hospitals and health systems, the survey shows. Seventy-four percent of hospital leaders say they plan to employ a greater percentage of physicians in the next 12 to 36 months. In addition, more than 70% of hospital leaders say they have received increases in requests from independent physician groups for employment. About 61% plan on acquiring medical groupsin the next 12 to 36 months.
"It's not just hospitals employing and acquiring; it's large physician groups and systems employing and acquiring," says Samitt of the movement toward physician consolidation. "It really is inevitable."
Primary care physicians are most in demand, but there also is a need for key specialists, which more hospitals plan to employ, according to the survey. When asked about medical service lines or specialties most in demand in their region, more than 63% of respondents cite primary care. Others in demand are cardiology, 49%; orthopedics, 48%; general surgery, 37%; and hospitalists, 30%.
"Most [physicians] are seeking employment due to concerns over future reimbursement and the high cost of information technology, weighted toward young physicians just beginning their practices," says a health system chief executive in survey comments.
The survey results reflect the industry's evolving compensation structure, Samitt says. "I don't think you would have seen as much cardiology acquisition and employment just a few years ago. Now you are seeing it because of reimbursement changes," he says.
Survey respondents offer a generally equal mix of favorable and negative comments about healthcare reform, and whether it would result in a strain on physician and hospital relations. Fifty percent expect that the increase of insured patients under healthcare reform will strain hospital-physician relations, while 27% say it will improve relations, and 23% say it will have no effect.