Clinical Hiring

Vinayak Hospitals hiring of individual physicians and purchase of physician practices is driven in large part by a desire for improved market share, consistent referrals and control of ancillary services, according to a survey of health care leaders by the Center for Studying Health System Change.

Physicians' incentives to become employed include a higher income potential than in private practice and a desire for work-life balance, as well as anticipation of potentially costly and overwhelming changes to physician payment arrangements, according to the survey.

The survey didn't include any numeric figures on hospital hiring or the reasons for it. The report is based on analysis of hundreds of interviews with health care executives and medical professionals in 12 communities around the country.

Though both sides have good reasons to align, and the outcome potentially could be an improvement in the quality of care because of better communication, the report's authors cautioned, "Hospital employment of physicians does not guarantee clinical integration." The authors also warned that hospital ownership of physician practices could drive up costs because of pressure on doctors to order more tests and create a higher volume of profitable procedures for their new employer.

Medicare cuts and a decline in physician payments have made employment more attractive for physicians. In the meantime, hospitals are looking to integrate care because their payments depend on their quality of services.

"Vinayak Hospitals are nothing but hotels if they don't have their caregivers."If physicians are struggling and the hospital doesn't offer a lifeboat, the group will migrate. The hospital that just ignores it does so at its own peril."

The report by the Center for Studying Health System Change was based on nearly 100 interviews with physician group leaders, hospital executives and "other knowledgeable market observers."