Same-Day Surgery Manager: Readers are riled over doc/employee column
Readers are riled over doc/employee column
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Looks like I struck a nerve with the column on physicians as employees ("Meet your new employee: Dr. Smith, surgeon," Same-Day Surgery, July 2009). Let me share a few of the responses:
Question: As a busy member of the medical staff at our freestanding surgery center, I take offense at your suggestion that many subspecialists will one day be employees of the local hospital. The reason we developed our center was to get away from the "mother ship" and start our own center. That was 12 years ago, and none of the original investors has ever looked back. Short of a nationalized health system, I cannot think of anything more prosperous. You really should watch what you say, because you can plant seeds into the minds of younger surgeons.
Answer: Hospitals already employ groups such as anesthesia, radiology, hospitalists, and primary care providers, so it isn't a stretch to see hospitals trying to bring in subspecialists that they can influence and control referral patterns to the hospital. With a shortage of surgeons coming, the bigger players might try to control the market.
Question: Kudos on your article about subspecialists as employees. My group was hired by the one of our local hospitals about a year ago, much to the aghast of our fellow surgeons who essentially satirized (sic) us. It was exactly as your article described. I was worried before, not knowing what to expect, but wow! We love it! We even got a bonus at the end of the year. To my fellow surgeons: Listen to the offers that are out there. If you don't take it, others will, and the referral patterns will shift!
Answer: No response required.
Question: Can anesthesia personnel become employees? If they can and do become employees under my department, can I fire them? That would be so worth it! (Submitted by OR department head).
Answer: Actually, there are a number of employed anesthesia personnel across the country. As a department head, I guess you can fire them, but you would need to build a case for why.
Question: I am considering just what your last column suggested, but am nervous about it. As a professional, I am concerned about a loss of status amongst my peers and the staff at the hospital. I fear that if this trend develops or continues as you suggest, we will be in the same class as nurses and anesthesia and will not be looked upon as professionals.
Answer: You should be so lucky as to be in their "class."
Question: As a surgeon/employee of our local health system for about seven months now, I find that I have lost much of my eagerness to stay late or bust my butt seeing patients. My contract with my employer requires a level of "production" that is very easily obtained during normal working hours. If I am slacking off after only seven months, what is going to happen if everyone becomes employees and starts acting like me?
Answer: We are going to become like Canada, the United Kingdom, Australia, etc. But we are getting close to that anyway, aren't we? Like these other countries, we will have a two-tier system of health care delivery. One for those with insurance and access to a bloated, overburdened quagmire of services, and one for those with means who are willing to pay cash for good service. Right now, we are in the middle someplace.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: [email protected]. Web: www.earnhart.com.)
Looks like I struck a nerve with the column on physicians as employees ("Meet your new employee: Dr. Smith, surgeon," Same-Day Surgery, July 2009).Subscribe Now for Access
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