Don't Confuse Integration With Employment

A recent survey of senior healthcare leaders showed what might best be described as a shocking lack of understanding of what is meant by “integration”. While more than 60% of those responding indicated that reform will result in better hospital/physician alignment more than half said that they would be increasing the number of employed physicians. Signing a paycheck does not assure alignment.


While physician employment is a valuable strategic tool that hospitals need to use to assure adequate physician coverage and a growing number of physicians seek employment as private practice becomes less attractive don’t think that this will translate to cost-effective quality care in a shared-risk environment.

Many hospitals have made practice purchase decisions because the physicians had been loyal members of the medical staff that historically brought business to the hospital. Maybe too much business if we were to examine clinical need. A network based on these physicians may not achieve the desired results. What if the most efficient physicians actually want to remain private. Does that exclude them from integration?

Integration is all about building trust, developing a dialogue, developing a care environment solely based on the best approach to clinical care, and getting beyond egos and turf and creating a patient-centric model. Employment has nothing to do with this process although some of the key physician might be employees. Focus on starting the journey and not on generating more paychecks. Recognize employment for what is is, a strategic tool.