Mastering the art of physician alignment: Employment, clinical councils

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Up until three years ago, Hospital Sisters Health System didn't have a formal physician employment strategy. Although the 13-hospital Catholic system in Wisconsin and Illinois recognized it was an important way to align physicians, particularly primary care, the strategy didn't solidify until recently.

Why the change in the health system with a 150-year old history? It's a mix of community relations, physician interest, and sights set on being the top in the nation.

"We want to be in the top 10 percent for quality, safety and service. And you clearly can't do that without physician involvement and support," Julie Stark Manas, president and CEO of Sacred Heart Hospital in Eau Claire, Wis., told FierceHealthcare in an interview.

Hospital Sisters Health System is actively developing care integration relationships with physician practices and hospitals in Illinois and Wisconsin through various arrangements, explained Manas, who also is division president of Hospital Sisters Health System.

Hospital Sisters' medical staff includes doctors from OakLeak Medical Network, a local 200-physician surgical practice, and Marshfield Clinic, a regional multi-specialty practice with 800 physicians. While OakLeak is committed to staying independent, the health system is considering another arrangement with Marshfield Clinic to acquire a 25-critical access hospital and 50-bed nursing home in a joint venture.

Today, there are 250 employed physicians in the system, a number that is expected to grow--"not in huge leaps and bounds but what strategically makes sense," Manas said.

The health system considers employment, as well as mergers and acquisitions, to fill possible holes in clinical practice. Employed physicians included surgeons, psychiatrists, rehab, pediatricians, OB, and occupational health physicians. For example, to create an in-house 24/7 hospitalist program in Illinois, the system hired six new physicians. And for the hospital system, the employment model has been successful in primary care and specialty, Manas said.

Along with employment, Manas touts the benefits of clinical councils for physician alignment. The councils of physicians guide operational and strategic decisions.

"We use those whenever we're making a big decision, trying to get their feedback from a physician's perspective," Manas said. "It's an important body that we have used."

In the annual physician satisfaction survey, doctors revealed they wanted to be more involved in the strategic decision making. That could run the gamut of expanding the physician lounge to adding on four more operating rooms.

"You'd be surprised how interested physicians can be," Manas said. "[They care about the] small decisions, as well as the big ones, because they feel so passionately about their community hospitals. … We certainly want to keep them involved as possible and for us, it's been successful."

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