Physicians Take the Lead

AMGA selected industry outsiders as its keynote speakers--Former Speaker of the House Newt Gingrich, Former Senator Bill Bradley, and economist Michael Porter--and though they differed on their approaches to reform, their common message was this: The healthcare system can only change from within.

That seemed to resonate with attendees, many of whom are already making innovative changes to improve care--and their bottom line--while they wait for the federal government to get its act together. Richard L. Reece, MD, thinks we're seeing the beginnings of a physician empowerment movement. Fed up with battling reimbursement cuts and waiting for a top-down solution to the broken healthcare system, physicians are mobilizing, innovating, and finally finding their collective voice, he says.

He cites involvement in online communities and increased political involvement as examples of physician empowerment, as well as physician-led practice innovations. Today's physician leaders want to focus on patient care, but to do so they are becoming more business savvy and taking an interest in the legal and political aspects of healthcare.

Take Barry L. Gross, MD, executive vice president and chief medical officer of Riverside Health System; when his organization faced some of the systemic problems that many practices encounter--physician shortages, crumbling reimbursement, Stark constraints--it used joint ventures and physician employment to transform into what he calls a "physician-centric health system."

The culmination of changes improved morale, retention, and grew the bottom line, and there are countless other physician innovators with similar stories about finding unique solutions to common problems across the country. (Note: If your medical group fits this category, you have two weeks left to submit an entry to our Top Leadership Teams contest.)

But some are also finding empowerment in shunning the system. A recent MGMA survey reveals that nearly 24% of physicians have already begun limiting or not accepting new Medicare patients, and nearly half may take similar steps if the 10.6% Medicare cut goes into effect in July. Other physicians are adopting concierge or cash-only practices to avoid the hassles of third-party involvement.

Whether physicians are able to collectively offer solutions to the systemic problems plaguing U.S. healthcare or are forced to work around them is not entirely in their control. But one thing is clear, Reece says: "There's a sense that the buck stops here and we've got to take a stand."

If you missed our coverage of the AMGA annual conference, here are some reports we filed from Orlando:

• Doc the Vote. Former Speaker of the House Newt Gingrich and former Senator Bill Bradley kicked off the AMGA annual conference in Orlando with 30,000-foot discussion of the healthcare system.
• Newt Speaks. I caught up with Gingrich after the session to follow up on some of his comments about insurance mandates and Republicans' plans for healthcare.
• Orchestrating Change. Carl Heltne, MD, president of Duluth Clinic and executive vice president of SMDC Health System discussed physician leadership development and how he turned around an organization characterized by low physician engagement and high turnover in leadership positions.
• Part-Time Problems. Cejka Search and AMGA unveiled the results of their 2007 Physician Retention Survey at the conference. The big news: The number of physicians practicing part-time is on the rise.
• Trends in Physician Retention. Senior Online Editor Rick Johnson sat down with Carol Westfall, president of Cejka Search, to talk about the growing number of part-time physicians and other results from the retention survey.
• Tracking Disparities. I spoke with Beth Averbeck, MD, associate medical director for care improvement with HealthPartners Medical Group, about her organization's approach to tracking and addressing racial and ethnic health disparities.