What Do Doctors Want from Your Organization? (Part 5 of 5)

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Wrapping up our series on the issues involved with organizations hiring physicians, based on this March 2013 article by Karen Minich-Pourshadi at HealthLeaders magazine, there are three words, she writes that should be echoed in any interview or discussion with potential physician employees: collaboration, communication, and metrics.

Mark Browne, M.D., MMM, CPE, FACPE, senior vice president and chief medical officer of Covenant Health, in Knoxville, Tenn., says it is imperative that you begin building immediately on “shared objectives and goals…knowing how these are being measured is a cornerstone to a mutually successful relationship” and “creating a strong hospital-physician alignment.”

Physician agreements need to be “based on performance standards, not just productivity,” he said. This begins with clearly delineating how you will be evaluating a physician’s quality of work.

According to Browne, “Physicians want to know, like anyone else, how they are measured and how they are doing if they are going to take on any risk. They need to be clear on how they will be measured and tracked, so you have to choose metrics that are reasonably easy to reproduce—and you don’t want 15 metrics, you want two to four. To encourage that alignment, there’s got to be a lot of conversations on the front end about how we can agree to hold each other accountable on quality, and you need to put it in the contract.”

To summarize Browne’s points, a strong hospital-physician alignment begins with having two to four reasonable assessment metrics. Those metrics then need to be clarified before a physician’s signature even reaches the contract. There should be no question from the physician or from the organization as to the obligations you’re expecting each other to meet.

This brings into play the way in which the contract is worded. Browne advises the following: Make it simple. Make it understandable. Make the goals achievable, yet challenging. “We’re openly sharing the metrics we’re tracking with our physicians so we can learn from each other, but it’s a work in process with population health.”

And to echo the original point from earlier in the series: don’t rush into hiring any one physician. Julie Manas, president and CEO of Sacred Heart Hospital in Eau Claire, Wis., and division president and CEO of the Western Wisconsin division of Hospital Sisters Health System, said, “There’s a lot of pressure within the marketplace to employ, and organizations sometimes make decisions based on the frenzy in the marketplace and not based on their due diligence.”

Browne says to keep employment as one of your options, not as your only option. “Physician employment needs to remain in the toolbox as an option, and if and when the timing is right for an organization, then it can be the right move.”

As we wrap up this series, what are your final thoughts on the ideas presented over the last five installments about the physician-employment trends? What advice would you offer your fellow healthcare executives on physician-hiring practices?

-by Pete Fernbaugh

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