Is physician employment the right move for hospitals?

Hospitals continue to buy medical practices at record pace, but is physician employment what's best for patients, doctors and hospitals?   

The number of physicians employed by hospitals jumped 34 percent between 2000 and 2010, according to the American Hospital Association. In 2004, hospitals conducted just 11 percent of physician searches, but that number grew to 64 percent in 2013, according to Merritt Hawkins.

By employing more physicians, hospitals can negotiate more favorable payment rates with insurers, the article states. In addition, more hospital physicians mean a reduction in variations in practice, and better care coordination between different specialties and health professionals, according to an article in The Atlantic. Using information systems to track physician behavior, the article states hospitals can garner more patients and generate more revenue.

However, physician employment means doctors lose some professional autonomy, must follow institutional rules and regulations, and even work under productivity quotes, according to the article.  

Feelings of losing control of their profession could also affect doctors' morale, according to the article, which cites a 1970s study that compared residents who made decisions for themselves and residents who relied on the nursing staff to take care of the schedule and other administrative decisions. After 18 months the residents who made their own decisions were more alert, active, cheerful and healthy than the less autonomous group.   

The Atlantic article argues that hospitals see financial reprieve by employing a lot of doctors, but patient care and physician morale could suffer in the long term. "To protect and promote the future health of the medical profession, it is important that physicians continue to base their decisions primarily on what is best for the patient, not what is best for the hospital," according to the article.

To learn more:
- check out the AHA statistics
- read the Merritt Hawkins findings (.pdf)
- here's the Atlantic article

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