Employed Physicians Less Engaged Than Hospitals May Think

Marcia Frellick

June 14, 2016

A new survey by staffing and technology company Jackson Healthcare finds that engagement levels for hospital-employed physicians are low, and hospital executives think physicians are more engaged than physicians say they are.

The number of hospital-owned physician practices has tripled, from 25% in 2002 to 75% in 2011, according to a 2011 Physician Compensation and Production Survey by the Medical Group Management Association. And the number of solo practitioner has dropped, from 41% in 1983 to 18% in 2012.

Jackson Healthcare's 2016 online survey of 1022 physicians and 127 healthcare executives found that, for the most part, the new employment structure has been satisfactory for physicians and executives. Almost all physicians (94%) who wanted to decrease administrative burden by selling their practice did so; 57% of those hoping to work fewer hours do work fewer; but only 32% of those expecting to make more money make more than they did in private practice, according to the report.

Among hospital executives, 70% reported their expectations were mostly or completely met.

Gaps in Perception

But levels of engagement are another story and this report finds a big gap in perception between what physicians say and what executives believe physicians would say.

Some examples of statements in the survey and viewpoints from both sides:

Statement % of Physicians Agreeing % of Hospital Execs Who Said Physicians Would Agree
Hospital name is trusted 62 81
Hospital always treats physicians fairly 46 68
Hospital always treats physicians with respect 48 78
Hospital delivers on what they promise physicians 45 66
Physicians have the staff and support to do their jobs well 42 60

 

Overall, physicians in primary care, family care, and ambulatory care were more engaged than surgical subspecialists, according to the report.

"That is good news for hospital and health system executives who are counting on the referral stream from these physicians," authors of the report write.

Of the internists group, 31% said they were engaged (4% of them fully engaged); 33% said they were not engaged; and 36% said they were actively disengaged.

Among surgical specialists, 22% reported they were engaged (3% fully engaged); 27% were not engaged; and more than half — 51% — said they were actively disengaged.

The study found no significant differences by age, sex, or region.

Two of the areas of engagement that had the strongest link to satisfaction are trust in the leadership team and good communication across health systems. But, authors of the report note, they are two of the areas rated lowest by physicians.

For instance, only 34% of physicians and 43% of hospital executives were satisfied with the level of communication across the hospital or health system.

Also, only 26% of physicians said they were involved in making decisions about administrative policy at their hospital or health system.

If hospitals can increase those scores, physicians' employment satisfaction will rise, the report concludes. If not, the gap will persist or widen.

"Unless hospital executives examine their cultures in light of the trend toward physician employment, they will be sustaining a group of physician employees that are happy enough to trade the administrative burden of operating a practice for a secure paycheck, work their shifts, punch their time cards and go home at the end of the day," the authors write.

The survey was conducted between March 17 and April 1. The error range was +/- 3.0 at a 95% confidence interval for the 1044 physicians who completed the survey, and +/-8.7% at a 95% confidence interval for the 127 hospital executives who completed the survey. Hospital executives qualified for the survey if their hospital of health system employs physicians as W-2s. Physicians qualified if they were hospital employees or if their practice was owned by a hospital or health system.

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