Hospitals put pressure on doctors to increase productivity

Hospitals continue to buy up more physician practices. At two healthcare systems in the country where that’s the case, the organizations are putting pressure on physicians to increase their productivity as they face major deficits.

Doctors at a large medical practice owned by St. Peter’s Health Partners in Albany, New York were warned about low productivity and those at Dartmouth-Hitchcock in Lebanon, New Hampshire, may soon face similar demands, according to news reports.

Executives at St. Peter’s Health Partners Medical Associates sent a letter in late August to doctors warning them of financial losses and suggesting higher productivity was needed, according to the (Albany) Times Union. The 350-doctor medical practice, owned by St. Peter’s Health Partners for three years, had a larger than expected loss as the fiscal year began in July, prompting the letter that stressed the “urgency” of the need for physicians to boost productivity, the newspaper said.

The medical practice was created in 2013 with St. Peter’s Health Partners acquisition of five independent physician practices and later grew as doctors and advance practitioners already employed by the health system were added. The letter said more than half of the doctors in the practice fell short of expected productivity levels, with fewer patient visits than the practice budgeted for, according to the news report.

Trustees at Dartmouth-Hitchcock, which has been beset by recent upheaval and is dealing with a surprise $23 million deficit, are considering putting in place productivity measures for its primary care doctors, according to the Valley News. Physician productively measures under consideration include changing scheduling practices so that doctors see 2.2 patients per hour and reviewing the work performance of doctors who score low on a national productivity scale that Medicare uses to assess and pay doctors, according to a proposal the newspaper said it obtained. Doctors who score in the lowest 30 percentile in productivity could be subject to individual improvement plans, while those in the lowest 15th percentile could need “justification’’ to maintain their positions.

Dartmouth-Hitchcock officials declined to comment, the publication said. The plan, with its focus on productivity measures, reflects “a new reality and it is a big adjustment,” one doctor, speaking anonymously, told the newspaper.