The end of a profession...

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drusso

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...when I started medical school 70% of MD's/DO's were self-employed. Now, it seems that we are more than willing to be bought, sold, and traded like a commodity

Some hospitals employing physicians see greater losses

By Beth Kutscher | December 30, 2014
Hospitals and health systems have been rapidly employing physicians to help meet the goals of healthcare reform, but the integration has been far from smooth, a new report notes.

A study from the Kentucky Hospital Association, conducted by Lexington, Ky.-based accounting and consulting firm Dean Dorton Allen Ford, found that local hospitals are incurring greater losses in 2014 than they did the prior year.

The results were based on a survey of 20 hospital executives in or near Kentucky.

A total of 58% of respondents reported losses exceeding $100,000 per physician in 2014, up from 41% in 2013. The report did not specifically spell out cost issues associated with employing physicians, but for every physician practice that a hospital or system absorbs, it must upgrade its information technology, pay comprehensive benefit packages and assume the costs of maintaining office space, equipment and staff.

Many healthcare executives argue that even if physician employment strains their balance sheets in the short-term, it's a key step toward creating clinically integrated networks that allow them to participate in risk-based payment models, such as accountable care organizations. More immediately, physician employment increases their referral base at a time when inpatient volume is falling each year.

However, the survey found that 42% of executives aren't tracking the downstream contributions from physician integration. And of those who are, there's no clear consensus on whether there's any downstream benefit at all.

There's every indication, meanwhile, that 2015 will be another robust year for buying physician practices, said Jeff Swearingen, who heads the physician services group at investment bank Edgemont Capital Partners.

The survey did find that losses were greater for hospitalists and specialists than for primary-care physicians. Hospitals are chiefly looking to integrate with office-based specialties, while physician outsourcing firms are rapidly buying up hospital-based specialties, Swearingen said.

The losses seen in the study did not correlate to hospital size. Losses accelerated the longer physicians had been employed, with greater losses seen when physicians were employed longer than seven years.

Hospitals and health systems with the greatest losses also were more likely to have considered or implemented a productivity-based compensation agreement or an alternative arrangement such as a joint operating agreement.


Follow Beth Kutscher on Twitter: @MHbkutscher

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"losses exceeding $100,000 per physician..." Freaking annoying. These imposters are framing it like docs are a burden on the delivery of "healthcare".
 
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"Losses", poor hospitals. They "lose" 100k on an Orthopod's office practice yet make over 5 million on all of the procedures done in the OR, tests and imaging studies ordered, PT, etc. that is not counted towards the "profit" from the physician's practice. All the while they demand more production from the physician. How much do the lose by paying all of the executives, managers, clipboard nurses, etc.? How much is spent on marketing and other non-patient care services.
 
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this lady beth kutscher is part of the problem….
that's not even "funny math" that's supposed to trick people. but if this kind of garbage fools even newly graduated docs then of course it will fool the average voter, etc.
 
In emergency medicine this has been going on for decades with contract management corps taking over.


But, you never know how this will play out in other specialties. If they get tired of losing dinero on docs (PCP's out number surgeons with facility fees to cash in on) it could reverse. Especially of the disemploy docs and still get the patients sent to their hospital.

You

Just

Never

Know
 
I think this may reflect the end of a business model, or mode of delivery, more so than an end of the profession.

This, however, is a little more to the point:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717820/


I think that it is more insidious than that:

http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html?m=1

http://www.forbes.com/sites/davidshaywitz/2014/12/24/rediscovering-medical-professionalism-2/

Most of what passes for "professionalism" at the large physician employers is just dressed up indoctrination, intimidation, and submission to authority. Physicians, being such "willing slaves" are happy to conform to the "rules" of population-based fuzzy thinking to the detriment of clinical "common sense."

Let's hope that 2015 is the year that physicians walk away from economic models the exploit their labor in order to redistribute resources away from patient care and into the bloated overhead and subsidized inefficiency.
 
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Let's hope that 2015 is the year that physicians walk away from economic models the exploit their labor in order to redistribute resources away from patient care and into the bloated overhead and subsidized inefficiency.

I don't think we'll have any good idea if things may turn around until after the 2016 elections. Until then, make preparations for the two tiered American health system.
 
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