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Nine Keys to Physician Alignment


Posted by Anonymous at 10/4/2017 11:14:14 AM

How to Align and Retain Physicians


Nine Keys to Physician Alignment

 By Phillip Miller

Last year, Modern Healthcare reported that hospital ownership of physician practices grew by 86% from 2012 to 2015, as hospitals acquired 31,000 physician practices (Hospital ownership of physician practices grows by 86% in three years. September 7, 2016). The article also noted that one in four physician practices are now owned by hospitals.

Physicians are embracing hospital employment as a safe harbor from the financial and bureaucratic burdens of private practice. However, that does not mean they are eager to realign their interests or modify their behaviors with a hospital simply because they have become employees.

Hospitals seeking to enhance physician alignment and retention should look beyond employment by implementing the following best practices: 


  • Understand the value physicians bring. Healthcare executives face many challenges that may obscure a key reality: physicians remain the fulcrum on which the health system turns. Physicians generate an average $1.5 million in revenue annually for their affiliated hospitals and drive the lion’s share of healthcare spending. In a value-based system, it is physicians who will largely determine if hospital quality, savings and reimbursement goals are achieved. They are a resource to be cultivated, not board pieces to be controlled. 
  • Consider the physicians’ perspective. Fifty-four percent of physicians surveyed by The Physicians Foundation/Merritt Hawkins described their morale as negative, while 63% are pessimistic about the future. Close to one-half are looking to make a change and about 12% relocate each year. Hospitals should start from the premise that many of their physicians are dissatisfied and have plenty of options to vote with their feet. 
  • Have a vision. Hospitals need to clearly articulate to physicians how they plan to navigate the turbulent waters of change. In particular, where does the hospital plan to be on the continuum between traditional fee-for-service and the fully integrated, risk-sharing model? Physicians who buy-into the vision may become more engaged while those who may impede the vision will have a chance to move on. 
  • Seek input. The only way to gauge the mood of medical staff members is to solicit their opinion. Hospitals should conduct an annual physician engagement survey asking doctors to rate hospital services and management, express their needs and concerns, and comment on their morale and practice plans. Hospital leaders then must demonstrate that they have responded to physician input and made appropriate changes. 
  • Recruit to retain. The seeds of physician turnover often are sowed during the recruiting process when expectations are not properly communicated. Hospitals should delineate in writing exactly what they expect from physicians in terms of hours, time-off, patient volumes, quality metrics, EHR use and related practice characteristics. 
  • Create an optimum workspace. What physicians desire above all else is a place where they can provide their patients with efficient, high quality care. It is critical that hospitals create the most physician- friendly workplace possible, with easy admissions, quick access to patient data, timely test turnaround, OR access, efficient triage and, yes, convenient parking. 
  • Provide clear, competitive compensation. There is an abundance of physician compensation data available and doctors generally know their market value. It is how compensation is structured, however, rather than the dollar amount that really counts today. Is the compensation formula clear and is it fair? Physicians are weary of confusing, constantly shifting compensation models, a fact underscored by Geisinger Health Systems’ recent move from value-based physician comp to straight salaries. 
  • Hire physician leaders. When physicians are asked to modify their behaviors they want to know the clinical and empirical reasons for doing so. They often are more amenable to change when the message is delivered by fellow physicians who understand what effect change will have on physician practice patterns and on patient well-being. 
  • Continually communicate. An annual survey is not enough. Hospital leaders must get to know their doctors and understand their world because in an evolving healthcare system they are going to sink or swim together.

Merritt Hawkins’ white paper, Ten Keys to Enhancing Physician/Hospital Relations and Reducing Burnout and Turnover, explores these and related concepts in more detail. Please email me here if you would like a copy.




Phillip Miller is Vice President of Communications for Merritt Hawkins and Staff Care, companies of AMN Healthcare. He can be reached here.


If you are interested in learning more about our advanced practice and physician staffing services, request an appointment with one of our experienced consultants.



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