Factors Driving Physician-Hospital Alignment in Orthopaedic Surgery

Page, Alexandra E.; Butler, Craig A.; Bozic, Kevin J.

doi:10.1007/s11999-012-2730-8

Cited by 23 publications

(12 citation statements)

References 16 publications

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“…Another example of health reform was Meaningful Use, a federal initiative for funding electronic health records (EHRs), as the cost and potential for EHR improvement could be a decisive factor for physician groups contemplating integration. [49] Market Structure. We found market structure to be another key environmental factor.…”

Section: Environmentmentioning

confidence: 99%

“…The reviewed articles sought to find alignment between the these factors with their counterparts on the hospital side. [46,50] Researchers also honed in on the generational culture shift of the physician workforce, in which younger physicians now have higher expectations for worklife balance, [17,40,44,49,50] no longer seeing the hospital as their social center.…”

Section: Physician Groupmentioning

confidence: 99%

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A conceptual model for physician-system integration: A scoping review

Nguyen

Wood

Johnson

et al. 2019

JHA

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Despite the widespread pursuit of physician-health system integration, the evidence for factors affecting successful integration is uncertain and inconclusive. We sought to identify and categorize the organizational factors in the current landscape of physician-health system integration. We conducted a scoping review of the empirical literature on this topic, first surveying the theoretical perspectives that have been used in past studies in order to determine how theory has been used to explain and predict changing integration strategies over time. Second, we extracted factors that have been used to define the environment, physician group, hospital, care coordination, and health system success. From the 29 eligible articles, bargaining-market power theory and transaction cost theory were the predominant theories applied. We identified 48 organizational factors that comprise the landscape of physician-system integration. Our findings cumulated in a conceptual model that may help health care executives, policymakers, and researchers more effectively address the complexities of integration.

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Section: Environmentmentioning

confidence: 99%

Section: Physician Groupmentioning

confidence: 99%

A conceptual model for physician-system integration: A scoping review

Nguyen

Wood

Johnson

et al. 2019

JHA

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“…Because more orthopedic procedures could be performed on an outpatient basis due to improved technology and techniques, surgeons were able to break hospitals' monopoly on the operating room by shifting the cases to ambulatory surgery cen-ters (ASCs). 5 Some orthopedic surgeons even pursued outright ownership of ASCs because declining reimbursements from surgical fees drove surgeons to seek additional income streams. Physician-owned ancillary services became another target for increasing income, with physicians offering physical therapy, laboratory, durable medical equipment, advanced imaging, and other services that had traditionally been the purview of the hospital.…”

Section: Historymentioning

confidence: 99%

“…Alignment projects involve the adaptation and application of some of the principles and practices of business success to the complex entity of health care. 5,6…”

Section: Historymentioning

confidence: 99%

Physician–Hospital Alignment in Orthopedic Surgery

Bushnell¹

2015

Orthopedics

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The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery.

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“…Several bystanders had contended that medical practice is increasingly dominated by dehumanized qualities, corporate necessities, machines and computer-operated diagnostic tools. [10][11][12][13][14] The answer remains in developing empathy among medical doctors. [15] Empathy has been considered as good equipment for medical doctors all over the globe to improve patient care, acquiescence and satisfaction.…”

mentioning

confidence: 99%