Published in the May 2010 issue of Today’s Hospitalist
WHAT DOES THE TREND toward integration in health care mean for hospitalists?
Hospitals everywhere are once again trying to dominate their local markets by integrating “if not buying outright “everything and everyone in sight. The list includes primary care physicians, specialists, and in many cases, hospitalists.
For years, a contingent in hospital medicine has said that the best way to “align” hospitalists with hospitals is by directly employing them. In their eyes, the integration of health care systems is another factor that will make the employed model more dominant.
But there’s another camp in hospital medicine that says that employing hospitalists isn’t the best way to get their attention. Hospitalist groups that aren’t on the hospital’s payroll, they argue, need to perform to keep their contract.
Does one particular type of program model “employed or outsourced ” have an edge in today’s health care market? Because there are so little data on the topic, we decided to try to answer that question in this month’s cover story.
The anecdotal evidence points to an environment in which hospitals are continuously raising the bar for their hospitalist programs. Groups that can’t meet hospitals’ higher expectations are being kicked to the curb, a trend that applies to both employed and private hospitalist groups.
We heard plenty of stories about hospitals that ditched their underperforming employed program. But we also heard stories about outsourced groups that were fired “or brought in-house “because of staffing and recruitment problems.
The bottom line seems to be that while individual hospitalists may have a bias that favors employed or outsourced programs, hospitals themselves aren’t wed to any one type of employment model for hospitalists. Perhaps even more importantly, many hospitals aren’t necessarily married to the program that’s currently in place.
Editor & Publisher