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Physician Independence Not Incompatible With Reform

Philip Betbeze, for HealthLeaders Media, January 27, 2012

He cautions health systems to be wary of envisioning large-scale physician employment as a panacea—something we write about frequently at HealthLeaders.

"[Employed] docs will come in and out of their jobs, and won't be fixtures in the community," he says. "Hospitals trying to 'own' their community will find their strategy will not necessarily pay off if they can't trust some of the care to those outside of the hospital. That will be necessary to do ACOs."

As the massive shakeup in healthcare continues, Libby envisions a point at which independents and employed docs will reach a new equilibrium, but he's not necessarily optimistic that independence will win out. He's sanguine about the prospects, but isn't convinced that employing a greater percentage of physicians will lead to higher quality healthcare.

"There will be a saturation point, but you disenfranchise the medical community when you remove the incentives for them to be responsible business owners," he says. "Medicine is a business. [Hospitals and health systems] will stop being so enamored of hiring physician groups and will realize that they are better off partnering with us.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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3 comments on "Physician Independence Not Incompatible With Reform"


Patrick Watterson (1/30/2012 at 12:49 PM)
As part of one of the few Physician/PA/NP owned practices in the Triad are, we are seeing many practices join hospitals. This is not always good for the community as the hospital needs admissions and ancillary services from these employed providers. Instead of a CT we can do in office for $700, the hospital is happy to do it and bill for $2500. One of the best things about our practice is we can change quickly where as larger practices/hospitals have to go to 8 committees to make a decision. Employment is not the cure for all that is wrong with health care.

bob (1/30/2012 at 9:21 AM)
Independence is no longer a viable option for the long run, but there are other ways to go besides employment by a hospital or any other organization. the best way is to form a real group practice organization, governed and managed by the members of the group. Such groups can contract with hospitals and health systems without losing control. Go group practice!

Nathan Kaufman (1/29/2012 at 10:32 AM)
Lack of scrutiny and Not being a cog in a wheel (a wheel that is hopefully led by physicians) has resulted in a health care system producing highly variable quality, abusive practices by a significant minority of providers, astronomically high costs, poor access and poorly coordinated care. Talk to the physicians Mayo or Virginia Mason about their impression of the highly fragmented independent physician model! Under an employment model you have to worry about how a bigger machine works.. not just the practice but the community's healthcare delivery system. And the scrutiny is coming regardless of if you are employed or not... tiered networks, value-based compensation for physicians etc. I wonder why Kaiser is one of the fastest growing health plans in the Fairfax area!!!!