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ACOs Shine Spotlight on Physician Employment

Carrie Vaughan, for HealthLeaders Media, May 10, 2011

"Some of our staff was getting a bit older, and if we wanted to decrease the practice load, it was not financially sustainable," says McCowen. "We thought about the options. One was to close the doors and walk away, but I have single mothers working for me and we love our employees, and the impact to the community and our patients would have been profound because we are the largest group locally."

So McCowen made some inquiries at Tacoma, WA-based Franciscan Health System along with another local health system that was ruled out early on because of cultural fit.

"It was a difficult decision after 30 years, but if we were going to survive to continue to serve the community and our patients, we had to do something," he says.

First, FMG, which is part of Franciscan Health, ­presented a compensation model based on national ­standards, McCowen says, explaining that there is no point in going through the process if the ­compensation model doesn't work. ­McCowen's practice also wanted to know the fair market value of its hard assets and whether its employees would have jobs.

In the end, any employee who wanted a job received a ­position, the practice received fair market value for hard assets, and the doctors were fairly compensated for the ­workload, says McCowen, who now has a role in the leadership and governance of FMG.

One of the major benefits of an employment model is zero administrative stress. "I have a lot of confidence in my level as an endocrinologist, but the [business] landscape has changed and it is a tough place," says McCowen.

And now that he is no longer burdened with administrative issues, McCowen says he has a new lease on what it means to be a doctor. "I love the practice of medicine, and it has allowed me the chance to rejuvenate my practice."

Medical group focuses on improving patient care
The driving factors behind Integrated Healthcare Associate's (IHA) decision to merge with Saint Joseph Mercy Health System, part of Novi, MI-based Trinity Health, differ substantially from many other physician practices that are choosing employment based on financial concerns.

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