How Private Practice Physician Attitudes are Changing

Physicians Practice's has published the results from their 2013 Great American Physician Survey.  The report with full data for this year’s survey will be available online in mid-August 2013 and in the September 2013 issue of Physicians Practice.

This year's survey has found that career satisfaction among private practice physicians has remained relatively stable since 2009.  There has been a trending towards hospital employment and hospital systems buying out or merging with smaller groups and private practices, however despite the changing healthcare environment and declining reimbursement private practice physicians have maintained their overall career satisfaction.

Results published in the article on Physician's Practice actually say the 2013 survey responses from partners/co-owners of private practices indicate that their level of career satisfaction may actually be increasing.  In 2013, more of these respondents than in previous years said they strongly agreed with the statement, "I like being a physician." More specifically, on a scale of one to five (with five being "strongly agree" and one being "strongly disagree") 62 percent of partners/co-owners said they strongly agreed with that statement. That's about 10 percent more than said they strongly agreed in 2009.

The 2013 survey findings also indicate that the number of private practices physicians that are happy with their career path has remained relatively stable over the past few years.  When asked, "If given the chance to go back in time and pick another career path, what would you do?" 60 percent of private practice respondents said they would do everything roughly the same way they did it the first time. That's about the same percentage as in previous years.

While most private practice physicians said they wouldn't change the past when it came to their career choices, more private practice physicians in 2013 said they would discourage their child from pursuing a career in medicine in the future. This year, about 18 percent of respondents said they would discourage a career in medicine. In previous years, only about 13 percent of private practice physicians said they would discourage it.

When other private practice physician responses to our 2013 survey findings are considered, it's not surprising that more physicians said they would discourage their children from seeking a career in medicine.

Over the past few years, private practice physicians have indicated that they are working longer hours, and more have also indicated that they feel they don't have as much time for their personal life as they think they should.

In 2013, for instance, 88 percent of private practice physician respondents told us that they worked more than 40 hours per week. In 2010, about 85 percent said they did. In addition, in 2013, 73 percent of private practice physician respondents said they don't have as much personal time as they think they should. That's up from 67 percent just last year.

In addition, more private practice physician respondents this year said they often wish they could change workplaces. In 2013, 31 percent of respondents said they wished they could change workplaces. That's up from just 23 percent in 2010. In addition, the percentage of private practice physician respondents who said they plan to become hospital employed in the next five years doubled between 2013 and 2012 (from 3 percent to 6 percent).

Read the full article by clicking here: http://www.physicianspractice.com/blog/how-private-practice-physician-attitudes-are-changing?GUID=98C7CA21-2AF6-465B-A27F-FC956DFC383F&rememberme=1&ts=26072013

Private Practice: Still Providing Control and Autonomy

Although the trend is towards hospital employment and many private and solo physician practices are being bought out or merging with larger hospital systems, there will always be a place for the private practice physician.

Some physicians will always seek the control and autonomy that only a traditional private practice can provide.

American Medical News just published an article on how some physicians will never transition in to an employed model, the strength of the private practice will prevail for some physicians despite economic hardships and pressure from larger health systems.

Read the full article by clicking here:
http://www.amednews.com/article/20130624/business/130629978/2/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130624

MGMA Physician Compensation 2013

The Medical Group Management has released their 2013 Physician Compensation and Production Survey report.  Most physicians, specialists, and surgeons pay increases were largely flat, however the study finds physician compensation across all generalists, specialists, and surgeons is becoming more and more based on quality measures, including the quality of care they provide and whether their patients are satisfied.

With the Affordable Care Act kicking in on January 1, 2014, the MGMA study comes as physicians are gearing up for the potential of millions more paying customers.

According to a recent article in Forbes, the health law and trends in the private sector are also beginning to influence doctor pay because employers, government and private insurers are beginning to move away from fee-for-service medicine to reimbursement tied to quality measures.

Read the full article in Forbes by clicking here: http://www.forbes.com/sites/brucejapsen/2013/06/12/doctor-pay-rises-to-221k-for-primary-care-396k-for-specialists/

Another article in HealthLeaders also reviews the data on the MGMA report based on 2012 data, agreeing that quality measures are emerging as components in physicians' compensation.  This trend is expected to grow as value-based reimbursements gradually supplant fee-for-service, volume-based models.

Read the full article in HealthLeaders Media by clicking here: http://www.healthleadersmedia.com/page-1/LED-293270/MGMA-Physician-Compensation-Increasingly-Based-on-Quality-Measures?goback=%2Egde_1170587_member_250288846

Physician Career Move: Make a Priority List Before You Make the Move

When physicians are looking for new career options, compensation and location are generally the prime motivators in considering possible options.  However personalizing your search based on your individual short and long term needs is essential to identifying a long-term, sustainable job opportunity.

Writing a list of priorities before you begin your job search will help to identify what your individual job search will look like.  

Be honest in your answers during your evaluation of potential opportunities and also during the interviews.  Don’t be afraid to ask appropriate questions during the interview.  The more you make your job search about your individual criteria, the more likely you are to identify an opportunity that is sustainable long-term and ensures the potential to live the life you want to live, in and outside of work.

Read a recent article from American Medical News suggesting a 4-step process to writing down your job search priorities:

http://www.amednews.com/article/20130603/business/130609985/4/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130603

How Much Revenue Does Your Specialty Generate for Your Hospital?

Becker's Hospital Review has released data on how much physicians average bringing in to a hospital by their specialty.  The data is based on Merritt Hawkins 2013 Physician Inpatient/Outpatient Revenue Survey.

Here are their published results:

•    Orthopedic surgery: $2.68 million
•    Cardiology (invasive): $2.17 million
•    Family practice: $2.07 million
•    General surgery: $1.86 million
•    Internal medicine: $1.84 million
•    Hematology/oncology: $1.76 million
•    Neurosurgery: $1.68 million
•    Obstetrics/gynecology: $1.44 million
•    Urology: $1.43 million
•    Gastroenterology: $1.39 million
•    Psychiatry: $1.30 million
•    Cardiology (noninvasive): $1.23 million
•    Nephrology: $1.18 million
•    Pulmonology: $1.01 million
•    Otolaryngology: $825,757
•    Pediatrics: $787,790
•    Ophthalmology: $725,000
•    Neurology: $691,406

To read the full article from Becker's Hospital Review, click here:
http://www.beckershospitalreview.com/hospital-physician-relationships/which-physicians-generate-the-most-revenue-for-hospitals.html

MedScape's Physician Compensation Update 2013

Hospital Employment is on the rise, MedScape analyzes physician compensation changes in the last year.

Overall most physicians, specialists, and surgeons experienced increased in salary, the stronger economy impacting a positive addition to income.  However there are still uncertainties with changes in government and healthcare law and healthcare reform making an impact on physician practices.

MedScape's report also reveals other practice elements including how many hours physicians worked, other changes to their practices, and overall satisfaction and contentment with healthcare and medicine.

Access the full report by clicking here:
http://www.medscape.com/features/slideshow/compensation/2013/public

Physician Contract Language: Hospital Bylaws

In this hospital employment dominant environment it's more important than ever for physicians to have a good understanding of their employment contract prior to signing with the hospital.  Hospital bylaws are another factor to make sure you understand before signing the contract.

Bylaws of a hospital govern the terms of the hospital's medical staff, including staff membership and clinical privileges.  Physicians need to review both their employment contract as well as the hospital's bylaws to understand the full aspects of employment, including what would happen if the physician lost their job or their staff privileges.

American Medical News has an article addressing how to review both an employment contract and the hospital bylaws prior to signing.  Read the full article by clicking here:

http://www.amednews.com/article/20130513/business/130519968/5/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130513

Physicians: Other Alternatives to Hospital Employment

There has been significant attention lately to the increasing trend in hospital employment, however selling your practice to a hospital or becoming a hospital employee isn't the only option for successful hospital/ physician relationship.

There are several different options physicians have to integrate with hospitals while still maintaining their autonomy and more control over how they run their practice, while still allowing a successful relationship with the hospital.

Because of the physician shortage and demand for services, hospitals are often are willing to work out alternative arrangements to hospital employment.

There are many different options physicians have to integrate their practices with a hospital, however according to practice consultants there are 3 main categories- limited, moderate and full.

Limited: physicians provide specific clinical oversight duties 

Moderate: hospitals and physician groups work toward shared goals

Full: not full hospital employment, however the hospital maintains more control over the physician group

To determine the appropriate alignment for your specific group it is important to establish you or your group's core values.  Meet with the hospital to determine how the physician(s) and hospital hope to achieve from the alignment.  There will be many meetings involved, both with the hospital and the physicians as well as third parties, such as consultants and lawyers.

Both parties should determine the physician's group practice issues and common goals.

Read the full article in American Medical News, or click here:

http://amednews.com/article/20130422/business/130429981/4/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130422 

Doctor-Owned Hospitals Prosper Under Health Law

Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth. The hospitals, many of which specialize in heart or orthopedic surgeries, have long drawn the ire of federal lawmakers and competitors. They say physicians often direct the best-insured and more lucrative cases to their own facilities, while leaving the most severely ill patients to others.


Some researchers say the doctors' financial interests encourage them to perform more tests and procedures, driving up the cost of care. The health law banned construction or expansion of these hospitals except in unusual circumstances.

But physician-owned hospitals have emerged as among the biggest winners under two programs in the health law. One rewards or penalizes hospitals based on how well they score on quality measures. The other penalizes hospitals where too many patients are readmitted after they leave. There are more than 260 hospitals owned by doctors scattered around 33 states. They are especially prevalent in Texas, Louisiana, Oklahoma, California and Kansas.

Of 161 physician-owned hospitals eligible to participate in the health law's quality programs, 122 are getting extra money and 39 are losing funds. Medicare is paying the average physician-owned hospital bonuses of 0.21 percent more for each patient during the fiscal year that runs through September. Meanwhile, the average hospital not run by doctors is losing 0.30 percent per Medicare patient.

Read the full article in Physician's News, or click here: http://www.physiciansnews.com/2013/04/16/doctor-owned-hospitals-prosper-under-health-law/?utm_source=4.16.13&utm_campaign=11713&utm_medium=email

Stronger Economy Stimulates Doctor Turnover

A recent Physician Retention Survey has determined many physicians are considering a new practice environment as a result of the strengthening economy.

There have been uncertainties in sustainability with the changing healthcare environment and how changes in healthcare reform and reimbursements may affect net compensation for physicians.  With positive media attention on a strengthening economy, many physicians are seeking out new, more stable employment opportunities.

According to the recent survey physician turnover has increased by the largest amount in 8 years.  If the economy continues to increase, the physician turnover is also expected to increase.  Many physicians will seek different employment opportunities or retire, as many were forced to delay retirement with a more tumultuous economy.

Turnover will come at a time when there is already a significant physician shortage.  

Read the full article including the full survey results in American Medical News, or click here:

http://amednews.com/article/20130401/business/130409979/2/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130401