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The Advocate
Third quarter 2007
Commentary: The Corporate Practice of Medicine and The Need for Physicians to Stay Engaged
By Terrance J. Sheehan, MD
President & CEO
It is important that we not withdraw from the kinds of discussions that shape the direction of healthcare policy when it comes to things like payer issues, legislative issues, and, yes, liability insurance.
There is no question
that more and more
doctors are opting to
earn their livings as
hospital employees
rather than private
practitioners. The
Maine Hospital Association reported in
2006 that 42 percent of the active physicians
licensed in Maine are employed by
hospitals. Many believe that that ratio
will exceed 50 percent when the MHA
revisits the question with a new survey
this coming year.
Why? Embarking on their new careers
with debt up to one hundred thousand
dollars or more for their education,
young doctors simply cannot afford the
start-up costs, nor the ramp-up time
associated with opening a private independent
practice. Thus they are increasingly
choosing the security of a regular
paycheck. Yet, it is not just recent medical
school graduates who are choosing
the route of hospital employment. In
more and more instances, experienced
specialists who have practiced privately
for years are choosing to move their practices
to their local institutions. For the
latter, it’s the continued reduction in
reimbursements and significant increases
in overhead that constantly threaten the
economic viability of the practice.
Couple that with the enviable prospect of
shedding additional business-related hassles
that take away from patient care like
meeting payroll, dealing with staffing
issues, managing benefits and savings
plans and the decision becomes easy.
Dual Perspectives, Dual Concerns
The choices are all personal and they all
make sense. They are simply part of an
undeniable and fast-growing trend in our
healthcare system — one that concerns
me in two ways. First, as a physician who
has seen major shifts, advances and challenges
in the medical industry over the
past 40 years, I’m concerned that the
voices of physicians may be lost when it
comes to shaping the future of the healthcare
system. Second, I’ve noticed that as
more and more physicians shed the burdens
of the business side of practicing
medicine, they also abdicate their role in
advocating for their own interests, particularly
when it comes to their own medical
professional liability coverage.
How to Stay Engaged
It is important that we not withdraw from the kinds of discussions that shape the direction of healthcare policy when it comes to things like payer issues, legislative issues, and, yes, liability insurance. And while it’s each individual’s prerogative, I am using this forum to urge physicians, especially those who have become employed by hospitals, to stay engaged in the issues of your industry — the issues that affect you and your patients. Be active in your state medical associations or societies, as well as your specialty societies. They play important roles in forming policies on myriad healthcare issues, some discreet, some farreaching, some local, and others national.
The thing is, if you are a doctor,
whether employed or in private practice,
you are bright, educated and informed
on the state of healthcare by virtue of
your day-to-day practice and interaction
with patients. You owe it to yourself and
to your patients to be a leader in the
cause and to make sure your voice is
heard on the issues of the day. I know
that hospital CEOs welcome your leadership
and partnership and they know their
physicians are the life blood of our
healthcare system.
Liability Insurance and the Importance of Maintaining Your Voice
From the Company’s standpoint, you
simply owe it to yourself to learn about
choices when it comes to medical professional
liability insurance. It is not a commodity.
Different companies take
different approaches to handling claims,
underwriting, risk management and legislative
initiatives like tort reform. You
don’t want your first insight into these
differences to come when you are facing
a lawsuit. If you’re at an institution that
does not have the protection of Medical
Mutual, help us help you by talking to
your hospital administrators about the
benefits of our program — and more
importantly, how they differ from others.
The long and the short of it is that
the way you make your living as a physician
is your decision. But, as a physician,
whether you choose private practice or
hospital employment, please remember
that you also have a voice in shaping
decisions on healthcare policy and, yes,
your professional liability insurance.