Doctors avoid conflicts with joint specialty care

Often, patients get conflicting advice from the different specialists they see, in part due to competition for business. This is particularly common among specialties like cardiology, vascular surgery, cardiac surgery and neurology, where the lines between specialties have begun to blur. To sidestep this issue, some specialists are forming groups that serve the hospital jointly, with guidelines requiring all physicians to work as a team. Not only does this improve collaboration between specialists, it also stands to enrich everyone involved, as participating doctors typically share revenue.

One example can be found at Massachusetts General Hospital (MGH), which has established a vascular center taking in seven related specialties. Rather than compete for patients, MGH expects the group's physicians to refer patients for procedures as a group, based on medical criteria--and new patients are rotated randomly from physician to physician. Brigham and Women's Hospital, a competitor, is negotiating a cooperative agreement between different specialties. It hopes to see that patients see multiple specialists during a single visit, get a single group treatment recommendation and receive just one bill.

To get more background on this approach:
- read this piece from The Boston Globe