How Physician Employment Is Changing — and What It Means for Healthcare Systems
All business sectors have to adapt to survive in today’s consumer-driven culture, and that includes healthcare. Traditional physician-owned-and-operated practices are diminishing. Research by the American Medical Association notes that in 2018, there were fewer physician owners than physicians employed by larger healthcare networks.
Healthcare networks loom large on the medical horizon, but many groups are having to learn how to operate these massive conglomerates as they grow. “Every healthcare system, especially the ones that are now employing and managing up to 5,000 physicians, with multi-fragmented campuses and multi-state design, are all learning on the job on how to manage such a large clinical empire,” says Travis Singleton, Executive Vice President at Merritt Hawkins.
So what does this mean for HR teams in the medical space? Here are some recent trends in healthcare employment makeup, and what they mean for the future of medical management.
The Effects of Centralized Healthcare
Enormous changes have occurred in the healthcare industry in the past three to five years. Many large healthcare systems, having acquired multiple practices, are now reaching the end of their initial plans. This is resulting in massive turnover in physician employment, making employee retention extremely difficult.
In the past, physicians with their own practice were linked to that practice’s patients. Now, however, more physicians are employed under an umbrella system, which gives them more systemic mobility. They are no longer attached to their patients.
Despite the goal of centralization, many healthcare systems are experiencing fragmentation. “This is a collection of leadership, a collection of cultures, a collection of different models on how to run quality, a collection of different views on scope, on patient care, on direction of that patient care — and you house them under one roof,” Singleton says. “Over time changes have occurred, leading to unrest within the system.”
What This Means for Management
Managing a staff as varied as now seen in healthcare networks is extremely complex. Mobility and turnover within the network make staffing tenuous. There has been an immense shift from private practice to the care team model, which many physicians are not accustomed to.
“That shift causes huge fluctuations on productivity, on patient satisfaction and ultimately in turnover,” Singleton says. “It's caused a much more dynamic clinical environment, and we all know healthcare systems aren't the best at dealing with those kinds of things, although they're getting better.”
Why Physician Leadership May Be the Answer
Physicians are necessarily at the forefront of modern healthcare, so it makes sense that they should be involved in identifying and managing initiatives in new systems. “Physicians are the bridge between administrators trying to get to where they think they should be and the clinical workforce that will carry out those missions,” Singleton says.
Physician executives also have the best effects on the most important part of the healthcare equation: the patient-consumer. Singleton says those systems that have made the most of physician executives have seen a rise in the quality of patient care. Physician-led teams tend to have a more intuitive understanding of the market, and of what patients are seeking in a healthcare system.
It’s paramount for HR teams in the healthcare space to stay apprised of the massive changes occurring in healthcare systems. Keeping the needs of the patient-consumer at the forefront is a great way to prioritize changes, and maintaining physician interdepartmental involvement facilitates that priority.