Hospitals: Ensure physicians know what employment really means

Hospital employment isn't for everyone, a reality that leaders from the LifePoint Health hospital chain strive to make clear to physicians before they join the organization.

Broadly, its physicians' loss of autonomy that can lead to "post-integration trauma syndrome," Daniel Sykes, a regional vice president of physician services at LifePoint, and Tim Godfrey, a senior director of practice management at the publicly traded company, told attendees at last week's Medical Group Management Association Annual Conference in Nashville.

To protect the time and investment that goes into recruiting a new physician, LifePoint makes it a priority to make sure doctors understand the potential tradeoffs, an article from Medscape explained. "We're always encouraging physicians to talk to other providers to understand what it means," said Sykes.

Some of the changes, per LifePoint rules, that can be difficult for physicians include the following:

  • Physicians must stop treating friends or relatives for free. While such "professional courtesy" arrangements are commonplace in private practice, employers that pay a physician's salary don't allow employees to give away company money via free care.
  • Discretion gives way to policy and schedules. Hospital employed physicians can't decide on a case-by-case basis when to send a patient's account to collections, for example, but must allow the hospital to do so on its predetermined schedule. Staff raises, too, are only possible at set times and amounts, and vacation times must be approved in advance.
  • Base salary will diminish over time. LifePoint will guarantee a salary close to what a physician was previously making for three months to a year, but over the next few years that base salary will decrease by about half and the doctor will be expected to earn the rest based on productivity measured by relative value units.

Another industry concern about hospital employment is that it can lead to conflicts of interest. The nonprofit hospital system Broward Health in Florida, for example, recently agreed to pay $70 million after whistleblowing physician Michael Reilly, M.D., and the U.S. Department of Justice sued the hospital for allegedly paying employed physicians kickbacks of millions of dollars to generate medical revenue through patient referrals.

Fifty-four percent of readers "strongly agree" and 26 percent "somewhat agree" with the whistleblower's position that hospitals should not hire physicians, according to Medscape poll. Eight percent of respondents said they "somewhat agree" with the statement while 12 percent "strongly disagree."

To learn more:
- read the article
- see the poll