“Fragmented and Fragile Workforce: A Discussion on Cultivating Hospital-Physician Cooperation.” A Review of a 64 Slide Powerpoint Slide Presentation by Kurt Mosley, Vice-President, Strategic Alliances, Merritt Hawkins,  AMN Healthcare

There are very few human beings who receive the truth , complete and staggering, by instant illumination. Most of them acquire it by fragment, on successive development, cellularly, like a laboratory mosaic.

Anais Nin (1903-1977), The Diary of Anais Nin

Live in fragments no longer.

Edward Morgan Forster (1879-1970), Howards End

Freedom is fragile and must be protected.

Germaine Greer (born 1939)

Recently Kurt Mosley of Merritt Hawkins AMN Heathcare, sent me a 64 slide presentation he is giving before hospitals,  physician organizations, and healthcare management associations across the country.

 In his talk,   Mosley describes the fragility and fragmentation of physicians,  as they try to respond to health reform pressures,  and how hospitals and doctors might react to lessen these pressures.

Hospital physician relations are a fragile thing.  

As a hospital CEO once explained,  “You can’t live with physicians and you can't live without them.” 

Under reform, the same is now true of physicians.   They can’t live with hospitals.  Indeed, they often compete with hospitals.  Increasingly, physicians  can’t live without hospitals .   Physicians simply don’t have the administrative,  technological, capital, and marketing resources to deal with the regulations,  rules,  demands, and mandates of Obamacare or of  similar  pressures of managed care and health plans.

In a sense,  hospitals,  or the so-called integrated health care organizations with hospitals at their core,  are replacing doctors’ offices.  This is understandable when you consider  in any given city in the U.S.  hospitals are the biggest business in town,  are the largest employer,  have the most political clout, and are the best equipped to deal with administrative demands of Obamacare.

That is why physicians are flocking to hospitals for employment,  why hospitals are growing to counteract Obamacare, why dominant hospitals can negotiate the best contracts with hospitals,  and why hospitals may own 75% of physician practices by 2020.

Mosley and Merritt Hawkins know this realities. 

 As a large physician recruiting firm, Merrit Hawkins knows:

·        More and more of their physician recruiting business comes from hospitals.

·        The physician union is fragile and fragmented , with just 50% of physicians saying they will practice as they do now over the next three years,  with the other 50% fragmenting becoming  hospital employees, retiring,  not accepting new Medicare and Medicaid patients, working part-time, working locum tenens or in concierge practices, or seeking employment either in or outside of medicine. 

The end result may be a physician shortage of unprecedented  magnitude with 83, 000 physician assistants and 155,000 nurse practitioners try to pick up the slack  to relieve physician shortages.  

What can hospitals do in concert with physicians to avert am access crisis?  New practice models? New innovations, such  as mobile. apps triage, virtual visits , mobile electronic  health records , in home implantable devices.

This talk spells out the options of “realignment, “ “collaboration, “ and “cooperation between hospitals and physicians, both of whom face decreased funding and reimbursement under Obamacare for the next ten years.

Tweet:  Over the next 10 years,  hospitals and physicians must cooperate and innovate to mitigate the effects of Obamacare  to contain costs.