The rate at which hospitals are employing physicians has gone up in many communities because of the need to increase revenue and market share of companies in the healthcare industry.
Orange County is the exceptions. For instance, in Boston, non-employed physicians are tightly kept in alignment with the dominant system of the hospital by physician organizations. In California, the law does not allow direct employment of physicians and includes northern part of New Jersey. Most physicians prefer operating alone or in groups based on the community.
O’Malley, Bond and Berenson argue that the relationship between physicians and hospitals has been weakened by various factors. Improved technology has contributed to decrease in reliability of physicians in hospitals. The number of physicians required in hospitals has been cut down by use of machinery in hospitals.
To increase market share, hospitals have begun to employ physicians to cover well-paid special services like orthopedic and cardiac care. Much attention has been drawn to employment of potential physicians in hospitals to enhance the quality and efficiency of medical services. Short-term employment for physician is also offered in hospital organizations.
The challenges faced by physicians encourage them to seek for employment in hospitals and other organizations. For instance, they desire to lead better lives, and they incur reimbursement for increased cost of private practice. Primary care Physicians (PCSs) find it hard to be independent because of the rise in overhead costs and flat reimbursement rates. This makes it difficult for significant generation of revenue through ancillary and procedure services.
According to O’Malley, Bond and Berenson, communication between in and out patient providers, even within the same institution is a major challenge. Pre and post hospital coordination of care in hospitals should be well integrated. In the current environment in which services are delivered in exchange for payment of some amount, communication remains a challenge for many hospitals.
The results of interviews in a Community Tracking Study (CTS) show that the number of physicians employed in hospitals has gone high. In most hospitals and health facilities, the number of part time or unemployed physicians are rebelling against the rules and regulations of the institutions they work for.
Their form of rebellion include failing to participate in medical staff committees that are usually comprised of medical workers, failing to pick emergency calls and establishing their private facilities other than the health institutions they work for. Physicians have to choose between two options, competing with hospitals or being employed in hospitals.
The voluntary medical staff model that was used to explain the existing relationship between physicians and hospitals has lost its relevance. Although voluntary medical services are still offered by some physicians, large numbers prefer getting employment in hospitals whereas others want to compete with the hospital. Heavy procedure-based specialties and other medical specialists may also be employed.
It is clear that there have been significant changes and challenges in the relationship between hospitals and physicians although other challenges still exist.
Bibliography
Casalino, Lawrence, November, Elizabeth, Berenson, Robert, and Pham, Hoangmai. “Hospital-physician relations: Two tracks and the decline of the voluntary medical staff model.” Health Affairs 27.5 (2008).
O’Malley, Ann, Bond, Amelia, and Berenson, Robert. “Rising Hospital Employment of Physicians: Better Quality, Higher Costs?” Center for Studying Health System Change 136 (2011).