This entertaining video pokes fun at some of the changes to the practice of medicine. Perhaps the changes aren’t as extreme as the video implies, but there is no doubt that it is changing. Like most things, the changes likely won’t be as drastic or terrible as some fear, but that doesn’t mean that physicians, and hospitals, don’t need to adapt. One change is the move toward more employed physicians. A recent study shows that nearly one third of first year residents desireemployment. (Perhaps because only 9% feel they are ready for the “business” of medicine?)While some hospitals see physician employment as a “simple” solution, it raises a whole host of problems:
- Recruiting physicians is a challenging, full time job.
- One of the reasons this is true is that physician turnover is higher than it should be and losing even one physician is extremely costly. (See our previous post on the real cost of physician turnover)
- Turnover is high because we sometimes fail to understand the expectations and needs of the physician or to fully define those of the hospital.
- Establishing clear performance goals and helping physicians to meet them.
- The problem of disruptive behavior seems pervasive and now these physicians are your employees, not independent practitioners.
- Hospitals expect these “employees” to be open to change and collaborative – traits not common in physicians.
Dr. Stoller points out that the selection process to medical school, the training and the professional socialization process almost eliminate the likelihood of developing the ability to collaborate. So, we have a vision of a new model of care – one driven by cost containment, quality metrics and collaboration, but the most important member of the healthcare team, the physician, is often ill-equipped to take the lead. This is quite a dilemma.
We are working with our hospital partners to develop a new approach: (1) Define the behaviors we are looking for in this “physician of the future”; (2) Develop these competencies and behaviors in the current medical staff; and (3) Deliberately evaluate these competencies in physician candidates before bringing them into the organization. In some instances, he or she simply won’t be the right fit and better to avoid investing hundreds of thousands of dollars when they are likely to be professionally unhappy and leave. In others, we can use this information to establish reasonable expectations about the physician’s place in the organization.
We aren’t trying to create “cyper-physicians”. The doctor patient relationship, pride in the profession and the “art” of medicine are still critical, but so is the ability to thrive in our new healthcare world.