Employed physicians must prioritize quality over business

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Amid increasing healthcare consolidation, the American Medical Association last week reminded physicians to put the interests of their patients before business interests, even if they are employed by hospitals, The New York Times reported.

"We never want patients to worry or wonder if a decision is being made in their best interest," Ardis Dee Hoven, a Kentucky internist and president-elect of the association, told the NYT.

Recruiting firm Merritt Hawkins predicts the industry will see 75 percent of the nation's physicians employed by hospitals by 2014.

American Hospital Association President Rick Umbdenstock agreed with the AMA and its physician employment guidelines issued last month on protecting patient care.

"Hospitals and doctors have a long history of being on the same page, doing what is best for patients," Umbdenstock said.

In addition to always putting patient care first, the AMA guidelines state that employed physicians--who should be members of the medical staff--must be "free to exercise their personal and professional judgment" and should not be considered breaching their employment agreements when they assert those interests. The clause implies that hospital employers not retaliate against physicians if they issue a treatment plan that conflicts with business interests or if they refer patients to an outside organization.

Regardless, as members of the medical staff, employed physicians should be subject to the same bylaws, including due process and peer review, the AMA said.

Hospital-physician employment deals need not pin quality care and business interests against each other. As recent data from the Hay Group points out, more agreements now include performance-based incentives that prioritize patient care. In fact, the consulting firm in November found that 63 percent among hospital-based physicians have annual incentive plans, which can include quality measures and patient satisfaction.

For more information:
- read the NYT article
- see the AMA principles for physician employment (.pdf)

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