On another social media site, a hospital administrator posed the following question:  ”What are your most challenging physician/hospital integration challenges?”  Here is my response:

In Oklahoma City, big challenges include making employed physicians refer surgical business to other hospital employees, not the best surgeons. Also making physician employees order unnecessary lab work and diagnostic tests in order to help earn their keep. Also, making the gastroenterologist employees do their scopes in the operating room rather than the lab with a general anesthetic so an extra $1000 hospital charge is generated, helping once again to pay the salaries of the Vichy doctors. Basically, training physicians to employ a mercenary attitude that leaves the patient completely disenfranchised is a great challenge. Justifying the million dollar salary of the nun running the Catholic Hospital Association has recently surfaced as a challenge, as well. Add to all of this the fact that my physician-owned surgery center across town charges 1/5-1/10 what the “not for profit” physician hiring hospitals charge, and the word of that is getting out to patients and employers. That is truly the new challenge for this corporatist model. Every physician employee I know feels completely disenfranchised and many have no intention of renewing their employment contracts. Putting window dressing on the problem will undoubtedly fool some doctors into thinking that they actually have some input. This model has never worked and I predict that for all of the money and energy devoted to it this time around, it will fail again, as it should.

He hasn’t responded yet.  
G. Keith Smith, M.D.