Physician Perceptions of Productivity Changes Post Health System Employment: A Mixed Method Case Study

Physician Perceptions of Productivity Changes Post Health System Employment: A Mixed Method Case Study

Author: 
Melissa Green
Program of study: 
D.H.A.
Abstract: 
Since 1985, health systems such as hospitals, clinics, diagnostic laboratories, and insurance plans have purchased physician practices to control market share, add value to their networks, secure physician supply, increase patient volume and referrals, and supersede value-based health care reimbursement. Physicians are also leaving private practice and joining health systems as compensated employees to counter reduced Medicare fee schedules, increased practice overhead costs, burnout from self-employment, and the desire for job security in the age of healthcare reform and uncertainty. However, physician productivity significantly declined after leaving practice and joining a health system. The purpose of this mixed method, sequential exploratory case study was to explore physicians’ perspectives of their productivity changes, if any, after a health system purchased their private practices. Semi-structured interviews gained the physicians’ perspectives of changes to production following the purchase of their practices. This data was supported by worked relative value units and cash collection data to demonstrate changes in production. Five themes emerged from the results. Physicians sold their practice due to government influences. Physicians sold their practice due to human factor influences. There was a perceived decline in productivity associated with the acquisition. There were no perceived changes in productivity post-acquisition. There were perceived changes in clinic operations post-acquisition.
Dedication: 
I would like to dedicate this journey to my father, who even after passing almost 30 years ago, continues to inspire me and to my husband and children, who have unceasingly supported my relentless desire to achieve my goals. Despite a computer constantly attached to me, they have been my rock; my foundation; and my light. Their encouragement has been my blessing. To my mother, the one who never judges me and always supports everything I do, with enthusiasm and compassion, even when it is craziness. I would like my children to know that this journey is my way of showing them that dreams are a reality and with heart, anything is possible. Be visionaries! Don’t ever let anything stand in your way of making a difference. Love what you do and be what you love. Be selfless; be free; and make your own path. Give to others. This will only make you a better person. Never stop dreaming and believe that your dreams will come true.
Acknowledgements: 
I would like to acknowledge the sincere dedication of my Chair, Dr. Amy Preiss, towards making me a better scholar and a better person. Her level of support and guidance far surpasses all expectations. She pushed for excellence and helped me rise to levels I didn’t know I could achieve. Dr. Preiss provided me encouragement, support, and collaboration and always knew exactly what I needed to hear, even if it was not what I wanted to hear. Thank you Dr. Preiss! Dr. Marzano and Dr. Underdahl’s expertise and encouragement were greatly appreciated and I truly value having two amazing committee members who have a level of expertise that contributes to my development as a scholar. Dr. Marzano and Dr. Underdahl provided affirmation and feedback that helped me believe in what I had worked so hard to create. They were an integral part of my journey and this experiences wouldn’t have been the same without them.