There has been an understandable and easily identifiable shift in practices from 2002 to 2009;
Physicians are signing on as employees, they are
selling practices or they are just not ever considering going into private practice at all.
In the recent survey, over 49 % of reporting practices were hospital or system owned. This is a significant increase (almost double) from 2002. As a malpractice insurance agency, advocating for comprehensive medical malpractice insurance coverage in California, we have to stay on top of the trends that may lead to increased claims.
Use of remote technology, an increase in patients due to the healthcare reform act (millions more now eligible to receive medical care) and less connection to the patients (presumed with an employer model) may result in an increase in frequency.
Physicians across the country, not just in California, are moving to an employee model of medical practice.
So, naturally, the important issue of incentivizing physicians and managing the work culture are moving to the forefront. Additionally, the large institutional systems that are now employing physicians have to be mindful of the complications of management, fairness, balance, equity and common employer civility.
Employment Practices Liability Insurance is available, still at affordable amounts, inexpensive premiums and should be strongly considered. Employment practices liability insurance policies can even be extended to include the third parties who work in hospitals and may allege sexual harassment or discrimination against another hospital employed physician.
Leading healthcare systems that employ physicians share similar priorities.
(this list is provided to us courtesy of an article in FAST Practice magazine, featuring dynamics in medical groups and advice of how to handle newly employed staff and many physician management issues.)
Lola Butcher explains that physicians want to
- Excel in Productivity
- Participate in quality improvement
- promote patient satisfaction
- Support system wide initiatives
- Teach, mentor and support younger physicians
- and demonstrate good citizenship.
There is a divide amongst physicians as to whether financial incentives work or lifestyle. What Hospital Systems do not want to do is to return to the disaster of the mid to early 90’s when they promised large salaries and benefits only to see that the hospital revenue could not support such promises.
According to the American Hospital Association, 2009, the top three desires for physician job satisfaction is not money..they are meaningful work that makes it a difference ..
a sense of community and regular feedback that affirms that they are providing services appreciated.
Physicians feel strongly about connecting with their patients, practicing their craft, trusting their science and feeling appreciated for this work.
The survey of physicians shows that hospital systems have to pay attention to financial incentives so that they do not attract unhappy, less skillful and less engaging physicians;
and, significantly, they (the employers) have to create supportive cultures where the work is appreciated.
If these employment model entities ensure that the proper medical malpractice insurance is in place covering all named business entities and facilities, aggressively look for all available malpractice insurance discounts and protect the institution against the financial effects of a large and costly employment practices liability insurance claim, they will be solvent, growing and strong enough to attract and retain the physicians necessary to make this model of practice a success.