Issue link: https://beckershealthcare.uberflip.com/i/717576
40 INTEGRATION STRATEGY 8. Orthopedic surgeon at a 700-bed hospital in the Midwest Q: What do you like most about your organization? "I think the hospital I work for is a phenomenal institution. As a whole, it's incredibly progressive and both the faculty and upper-level management understand the changes in the healthcare industry and are adaptive to those changes." Q: What do you dislike most? "e institution is large, so some of the minute details of the day- to-day work get lost in the bigger picture. It's also a very specialized center — it isn't necessarily primary care-based, and that may not be what's best for the future. It's still an incredible institution in terms of its attention to private practice and academic needs." Q: What do you wish the CEO did differently? "Our CEO is a physician himself, so he really understands what oth- er physicians need. My only complaint is as he's getting older, there isn't as much of an emphasis on face-to-face interaction with other physicians. It doesn't detract from the work that he's doing, but it's something I wish would change a little bit." 9. Orthopedic surgeon at a 900-bed hospital in the Midwest Q: What do you like most about your organization? "Our institution has a really good reputation in the medical field, which means there's a number of opportunities to pursue research — specifically surgical research. e facility is constantly introducing new technology and innovations. But its reputation is key; patients recognize the name and are much more willing to participate in stud- ies. It also provides a sense of security for them, knowing their infor- mation won't be shared." Q: What do you dislike most? "e institution is separated into two entities. ere's the medical school and there's the hospital system. ere's this internal struggle between the research/education aspect and the profit, corporate side, and physicians are stuck in the middle. We're employed through the hospital, not the university, so whenever the executive management communicates with us, the metrics are entirely corporate-driven — such as the number of patients we see daily, etc. As a result, the re- search/education falls behind. ere needs to be more of a balance between the education and profit sectors. It feels almost like we're replaceable cogs in the machine. You can't expect physicians to be en- gaged, it just doesn't work like that." Q: What do you wish the CEO did differently? "Our CEO is completely removed from our daily operations and any sort of interaction with the physicians that practice here. If you put our CEO in a room full of doctors, I can bet you that they won't know who he is and he won't know which doctors are actually employed by the hospital. ere is this huge disassociation between C-suite management and physicians. at division doesn't necessarily exist in smaller hospitals, but it's much more common in bigger ones." Additional comment "I believe employment does not equal engagement. Surgeons are different from other specialties, like general medicine or emergency room physicians. You can't expect automatic engagement. All these deals between doctors and upper management crumble because phy- sicians don't care. You have to figure out a way to make them engaged within the hospital's mission. If your goal is to make profit, profit, profit, figure out a way to make the physicians more invested in mak- ing a profit — pay them more. If your goal is to be a leading research facility, figure out a way for your doctors to want to do research." 10. Orthopedic surgeon at an independent specialty group in partnership with Midwestern hospitals Q: What do you like most about your organization? "I like that our organization is able to provide a complete spectrum of care. Everyone employed here has the same goals, and we have the resources to provide patients with that type of care." Q: What do you dislike most? "My biggest issue is the amount of paperwork we have to do; it doesn't improve the quality of care we're able to offer our patients. It's bur- densome. Also, insurance companies don't want to reimburse us, it's almost a game they're playing. [Tests and] procedures get bundled together so the insurers pay us less. As physicians, we're increasingly paid less for the same work while the cost of doing business keeps going up. All of it really hinders our ability to provide patients with the care they deserve." Q: What do you wish the CEO did differently? "A lot of CEOs have a bias based on past interactions with physicians. ey're not willing to alter their business plan or model. For exam- ple, we work with a health system that will only work with physicians employed by their facility — they won't work with independent physi- cians. I strongly believe that one model doesn't always work; you need to modify it to fit the situation and you need to be open to modifica- tion." Additional comment "e way the industry is going, [if ] physicians aren't independent, they become a commodity. ey're bought and sold in the market. If you lose that independence as a physician, you can't make decisions. Large health systems may not have patients' interests at heart. Instead of quality, profit and loss is what drives most systems, and because they're so preoccupied with cost, they may not hire the best physicians because the best are not the cheapest." 11. Employed physician at an 800-bed hospital in the Midwest Q: What do you like most about your organization? "What I like most about the organization is the ability to interact and work with folks who share the same mission and vision of the future. at helps a lot. It helps that everybody is striving toward the same goal, rather than people wanting to go in their own direction." Q: What do you dislike most? "Like every big organization, there is bureaucracy. It is partially inev- itable, and I guess what attracts people to smaller organizations and private practice is the fact that they don't have to deal with bureaucra- cy. Sometimes you understand why decisions are made a certain way and sometimes you don't."