Employed or Self-employed: Did You Make the Right Choice?

Leigh Page


October 12, 2016

In This Article

Hospitals Work to Improve Engagement

Everyone is talking about recruiting employed physicians into hospital leadership.

"Doctors must step up and play a leadership role within the organization," Dr Drummond wrote in his article on employed physicians.[4] "Don't fight and object and resist. Dive in and lead. Without strong physician leadership in your organization, you have little or no influence on the administration and in the board room."

Dr Drummond added that organizations must carve out enough paid time for physician leaders to do their work. "Where do you find the time for the committee work to represent the doctor's interests in your busy practice?" he asked. "Does your organization respect these leadership activities enough to compensate you fairly for them?"

Physicians need training in leadership skills, he wrote, because nothing in their background—even experience with running a practice—prepares them for it. In a large organization, "the rules of influence are very different than in a smaller, physician-led private practice." he wrote.

Sutter Medical Group, affiliated with Sutter Health in Northern California, has been identifying and training more physician leaders. Sue Gotelli, director of physician leadership development for Sutter Health, spoke about Sutter's efforts at the American Medical Group Association's annual conference in March.[9] Sutter is "looking at how we treat populations of patients with specific clinical conditions, so there's a need for a lot of service line leaders," she said.

The first step is to bring administrators and physicians together in one room, Dr Proscia says. His union has been facilitating regular meetings between its members and executives at Health and Hospitals, the public hospital system for New York City.[10] In workshops created by the Institute for Healthcare Improvement,"everyone is discussing how they can programmatically improve things," he says.

Some physicians are skeptical that putting employed physicians into leadership roles will help. Hospitals don't want physician leadership; they want "followership," wrote Gregory Patrick, MD, a Pennsylvania pulmonologist in a response at the end of the Health Affairs article.[8]

He warned that designated physicians will become puppets of management, and employed physicians will continue to be in the dark.

"Hospital hierarchies are notorious for a lack of transparency or a willingness to explain how their proposal will improve care for the individual patient or improve the life of the individual MD, or why the individual MD should embrace their proposal," Dr Patrick wrote.[8]


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