Medical Mutual Insurance Company of Maine

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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.