Amid Change, Physicians are Faced With a Choice

Amid massive change in our healthcare delivery systems and seismic shifts in many regional markets, physicians are increasingly being faced with a simple choice: be acquired or become employed as part of a large healthcare system, or stay independent while offering a compelling service that hospitals and health systems value. 

The changes occurring in our care delivery systems have generated great interest, innovation, and yes, fear among many in healthcare, doctors included. Some recent news stories (here and here) have documented physician practices under severe financial stress, or even going bankrupt. Others note the formation of gigantic health systems (see here) and growth of Accountable Care Organizations.

So what is a physician to do when evaluating their options?

Physicians (and physician groups) have a critical decision to make. Will doctors become an employee of an entity that delivers care, or a valued partner and consultant to that entity? Both paths are available, but whether the one you choose works out for the best or turns out to be an absolute disaster depends on how deliberately you approach your value as a doctor within the healthcare system.

Thinking deliberately means putting aside the standard complaints I hear so often from doctors today about how tough their decisions are, whether it’s about rising overhead pressures, decreasing reimbursements, government regulation, or fights with insurance companies, and instead taking time to think about themselves as clinicians and healthcare practitioners.

If worrying about those pressures is too much, your choice is easy. Pick a partner and approach your local or regional health system about becoming a part of them. They have enormous resources and should be equipped to better manage this market transition, wherever it may lead. You can still complain about them being too (pick your adjective) big, ineffective, slow moving, unconcerned, etc. The reality is if you have decided you can’t provide a compelling and unique service that is worth marketing and offering then you have sealed your fate.

On the other hand, market consolidation, with more and more physicians becoming employees of large health systems, isn’t necessarily the best way forward. Suppose you or your group offer a unique service. It could be how you manage patients with high risk diagnoses, complementary and alternative medicine offerings, a unique way of managing patients with obesity or an innovative home health product.

In that case you can approach your hospital system, and others, about providing that service in a partnership setting. Partnership involves taking a risk and providing a service that someone else values. It means investing in a product or service to seek a better outcome. The system will reward you IF you have proven that it works and someone trusts that you can do it better, faster and yes cheaper than they could themselves.

That is not a bad thing. Partnerships are where innovation and ideas are fostered and honed. Some of those ideas work and deliver incredible results. Some fail because they do not deliver, address the wrong issue or are ill-timed. That doesn’t mean we should stop trying to innovate. When I speak with health system leaders I am struck that they have the same concerns about the proper positioning of resources, where they need to invest and where they are going to find good partners to help them navigate this time of transition.

Nearly all physicians do what they think is in the best interest of their patients. But the fact is, some do it better than others and deliver better results and a higher value. The value equation means higher quality, lower cost and a better patient experience.

In the end physicians, and physician groups, have a choice when it comes to their fate. The path each takes will be intentional, or not. Whether we want to admit it or not, we hold our fate in our own hands.