Improving Physician Integration Culture

With the trend of hospital employment and practice buy-outs, one sensitive aspect of the transition is the cultural clash that occurs between hospitals and physicians. To alleviate the challenges of hospital-physician integration, focus on leadership, teamwork, and communication; this according to a study by Healthcare Financial Management Association (HFMA) magazine.

According to a recent Accenture Health report, by 2013 less than 1/3 of physician practices will remain independent; in addition, healthcare mergers and acquisitions have hit an all-time high. Merger and acquisition deals are 26% more likely to be successful if all parties pay attention to resolving cultural differences during the negotiation and prior to the implementation of the new hospital group.

Culture can run the gamut of treatment of patients, referring physicians, and employees; decision-making process; performance rewards; risk; and quality and costs. Just as important is identifying who the leaders are in the physician practice and the hospital. The merging organizations should use these representatives to drive the process and communicate every step to each other.

A merger, buy-out, or lease of a practice can be more successful from the beginning if hospitals and physicians develop a measurable vision, understand the joint agreement, implement an organizational communication plan, analyze results, and measure cultural alignment.

Read the full article in Healthcare Financial Management Association magazine, or click here:

http://www.hfma.org/Publications/hfm-Magazine/Archives/2011/July/Culture-Clash--The-Impact-of-Culture-on-Physician-Hospital-Integration/

Rewards of Staying in a Private Practice

There has been so much reported on the decreasing number of private practices, it is refreshing to read about the rewards of staying in a private practice.

Although the hospital employment model has become more attractive to many physicians seeking new positions, the private practice model will always appeal to some physicians and there will be a market for the private practice, even in today's changing healthcare climate.

Some physicians, particularly those more entrepreneurial-minded, will always prefer to control how they wish to run their practice and not be 'owned' by a hospital which will dictate how they must operate their practice. They will deal with all aspects of running a practice including billing and overhead, however they can have 100% decision making power and elect how they wish to market and present their practice.


Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/07/18/bica0718.htm

Hospital Employment Alternative: Lease Your Practice to a Hospital

There has been a lot of press on the trend toward hospital employment, driven from both physician candidates seeking new positions as well as hospital's desiring for employed physicians to be a go-to in-house resource.

This article from American Medical News provides an alternative to a typical hospital employment model: private practices can actually lease their practices to a hospital.

Although these terms can vary significantly, a private practice can often maintain most control over how their practice is run. Normally the hospitals lease hard-assets as opposed to purchasing the practice and creating a hospital employed situation for the physicians. Or, a lease can be an experiment for a private practice to see how it would be affected if the practice did decide eventually to sell to a hospital.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/06/13/bica0613.htm

S&P: Outlook for Hospital Finances Bright

Standard & Poor's managing director of non-profit healthcare ratings has a generally positive outlook for healthcare facilities for the next couple of years. Martin Arrick, S&P's Managing Director, said in their annual conference many of the financial conditions of 2008 and 2009 have stabilized.

He added that S&P's upgrades outpaced downgrades by a significant margin in 2011. Many hospitals and systems that received downgrades in recent years have bounced back.

He observed that providers must negotiate a "new normal" of flat patient volumes and growth, which continues to pressure them to cut expenses. Also, the state governments will continue to cut Medicaid and other portions of their budgets that can affect the bottom lines of hospitals.

One thing that has yet to be determined is the affect health care reform will have on hospital's bottom line and how many new patients hospitals will see.

Read the full article in Fierce Healthcare Finance, or click here:

http://www.fiercehealthfinance.com/story/sp-outlook-hospital-finances-bright/2011-06-27?utm_medium=nl&utm_source=internal

Physicians Still in Strong Demand

Despite the decrease in positions across the board in all industries and even now a slight increase in healthcare positions, demand for physicians in all specialties is still increasing. In fact, according to data released by the U.S. Bureau of Labor Statistics, medicine continued to be one of the few economic sectors still creating jobs in their June released report.

Physician positions appeared to have increased in all specialties with of course the most dramatic increase in primary care and internal medicine physicians.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/06/13/bisd0614.htm

Added Incentive to Recruit Recruit Elder Care Specialists and Physicians

Fewer than 400 geriatricians a year emerge from academic training programs, partly for perceptual reasons (students see it as a depressing field, though its practitioners find it very satisfying) but partly for financial ones. With virtually all their patients on Medicare, geriatricians are the least paid of all medical specialists. They are actually penalized for their decision to care for old people. After three years as internal medicine residents, their income drops by $15,000 if they complete the fourth year of training required to become a geriatrician. More training equals even less money.

Geriatrics specialists, incredibly, are not included in the federal law governing eligibility for the National Health Service Corps. The National Health Service Corps offers a loan forgiveness program to help pay off the staggering debt that many health professionals, including physicians, incur as students. Established to increase the supply of primary care practitioners, the corps allows geriatrics specialists to participate for now because of an intervention of the secretary of health and human services. But unlike professionals in family and internal medicine, and in pediatrics, the inclusion of geriatrics specialists is recent and impermanent. A future secretary could bounce them.

The Eldercare Workforce Alliance has proposed a modification to add geriatrics specialists to the corps' governing legislation. It's a simple bill, just 29 words long including the title, the Caring for an Aging America Act. It requires no additional expenditures, though if it succeeds in drawing more people into service, Congress might eventually decide to increase the corps' appropriation.

Read the full article in the New York Times, or click here: http://newoldage.blogs.nytimes.com/2011/06/20/a-missed-opportunity-to-recruit-specialists-in-elder-care/?ref=health

MGMA Report on Physician Compensation

MGMA will release their annual report next month, Physician Compensation and Production Survey: 2011 Report Based on 2010 Data. While the data obviously varies significantly by specialty, one common trend is geography. The report found that median compensation was highest in the southern states for both primary care physicians and specialists.

Another trend the report sited was the increase in physicians moving to hospital employed positions as opposed to starting solo practices or joining existing private practices. This has been discussed frequently over the last several months in multiple media outlets.

Whether physicians are looking for their first job out of training or looking to change positions, there are so many other factors aside from compensation they need to take in to consideration. Quality of life is a big factor many younger physicians are seeking in their job search. Shared call, guaranteed salary, vacation, and location are all important to provide physicians a balance in their life.

The private practice model is not completely dying out, there will always be a market for physicians who want to have full control over their practice and how they operate. It also doesn’t necessarily mean working 80+ hours per week to make decent income. Physicians can still enjoy a good quality of life in a private model with shared call and managed care organizations.

Whatever physicians today are seeking in their job search, there are many employment models to choose from. Models can sometimes be negotiated to in order to tailor to a physician’s preferences. It’s important with the changing healthcare environment both physicians and hiring organizations, whether they be hospitals, academic institutions, or private practices, are flexible in their negotiations to ensure both parties make a successful, long term placement.

Read the full article in HealthLeaders Media, or click here: http://www.healthleadersmedia.com/content/TEC-267467/MGMA-Mixed-Movement-on-Physician-Compensation##

Physician Career Realties vs. Physician Career Expectations

This article is written highlighting Neurosurgery, although the same principals can be applied to other physician specialties.

In medical school and residency, training programs do a great job of teaching medical students clinical duties. However, how effectively do they teach future physicians real-life lessons on how to run or be a part of a practice?

At our physician recruiting firm we see higher percentages than even this article references, 50-60%+ of physicians changing jobs after their first contract out of training. It is so important for physicians to consider all of their motivating factors in their first job to avoid looking for another position once the first contract is up. This includes everything from call, location, community amenities, salary, bonuses, partnership, academic pursuits/ opportunities, and family.

To ensure physicians accept jobs out of training that fit what they are looking for not only in a position but also in a way of life and family they need to consider all factors in how they want to practice and how they want to live their lives.

Read the full article in the Congress of Neurological Surgeons, or click here:
http://www.cns.org/jps/MismatchedCareerExpectationsandRealitiesinNeurosurgery.pdf

Slight Increase in Academic Physician Compensation

Typically academic physician positions are compensated less than private practice and hospital employed physicians. Not only because more of their time is devoted to teaching and research, but also because the motivation to be an academic physician is generally based more on professional fulfillment and self actualization, in addition to contributing to the next generation of medicine. That is why it was inspiring that academic physicians experienced a slight increase in pay comparing 2009to 2010.

Academic faculty physicians in primary and specialty care enjoyed a slight boost in compensation according to Medical Group Management Association's (MGMA) report. Academic physicians that benefited from a slight increase were primary care, pulmonary medicine, and non-invasive cardiologists.

Read the full article in Fierce Practice Management, or click here:
http://www.fiercepracticemanagement.com/story/mgma-academic-physician-comp-slightly/2011-03-16

In fact, academic physicians are Maryland's top earners, even considering athletic and top government incomes. Read the full article in the Baltimore Sun or click here: http://www.baltimoresun.com/news/maryland/bs-md-state-salaries-20110517,0,4888916,full.story

Why Physician Compensation Plans Fail

The number one reason physicians leave their practice is discontent over their compensation. During the signing and negotiating process, many long-term compensation issues are not addressed and it leaves the physician unsatisfied with the compensation terms and less likely to re-sign a similar contract with the same group. Also, physicians are often not communicated with during their contract term and these issues are either not brought up prior to the contract completion or are not taken seriously enough to make changes that may keep the physician for another contract period.

MedScape has published their 2011 Physician Compensation Survey which provides data on many different specialty's compensation tracking geographic location, specialty, and even gender. View the results by clicking here:
http://www.medscape.com/features/slideshow/compensation/2011

They have also offered some guidelines on how to create compensation plans that work, not only during the negotiation process but also long-term once groups have signed physicians.

Here are some of their suggestions:

-Create a Compensation Plan with a goal of Preserving the Physician Group
-Annual Review of the Compensation Plan
-Structure Compensation Plans Specific to each Separate Physician Partner/ Associate

Read the full article at MedScape or by clicking here:
http://www.medscape.com/viewarticle/741975