Despite disturbing trends of hospitals and HMOs losing money on physician affiliations, developing strengthened physician relationships is critical to surviving a healthcare
environment plagued by reimbursement cutbacks. In 1998, health systems lost an average of $111,000 per physician, according to an Ernst & Young survey.
Solving this riddle, will rely heavily on restructuring physician partnerships by using better communication strategies and having more realistic business expectations,
suggests Physician and Hospital Solutions (PHS), a healthcare consulting firm in Denver. PHS develops strategies for helping physicians, hospitals and HMOs carve out mutually
beneficial relationships through managed care training, corrective action plans, contract negotiation and operational assessments.
Although hospital-physician relationships have soured across the country, in both urban and rural communities, the inescapable reality is that hospitals can't increase market
share without solid physician participation and physicians can't practice medicine unless they become more managed-care savvy.
By spearheading efforts to strengthen communications with physicians through targeted managed care education, marketers and corporate communicators can play a pivotal role in
helping hospitals and HMOs redefine their relationships with physicians.
These opportunities were explored when HPRMN recently spoke with David White, PHS' chief operating officer and Cary Shames, PHS' chief medical officer.
HPRMN: What role can communicators play in strengthening physician relationships?
David White: There's a very strong opportunity for [marketers and corporate communicators] to make sure that physicians receive messages that are consistent with the hospital's
mission and reinforced through action.
We're going to see physician groups and hospital systems coming together to present evidence-based data on [healthcare] quality and utilization. The marketing of the future
will be driven by these outcomes to increase market share and to address a new wave of [healthcare] consumerism where consumers are taking more control of their healthcare by
educating themselves on the latest drugs and healthcare treatments.
Cary Shames: It's also a good idea to look outside healthcare at other industries that have developed creative partnering strategies to respond to a new business climate. In
the early '90s, industries like telecommunications and banking/finance had to reinvent themselves - in terms of corporate structure - to survive.
HPRMN: Where are some of the most significant communication breakdowns?
DW: The communication breakdowns are from A to Z. Physicians and hospitals are speaking different languages across the board, from business and utilization to quality
management. Managing a hospital is 180 degrees different than managing a physician practice. Although there are different management realities, there is a true interdependence
[between hospitals and physician practices] that needs to be better observed so that the best of each can be incorporated into a successful relationship.
Historically, the hospital-physician relationship has gone through a five-stage process of hospital dominance, physician group emergence, hospital re-entrenchment, competition
and cooperation/partnering. The last stage is where hospitals and physicians need to be. This is where new creative ideas should be pursued to improve quality, cut costs and
respond to the new age of healthcare consumerism. Hospitals and physicians need to adopt a common mission where physicians control utilization and hospitals recognize physicians
as more than a line item on a balance sheet.
HPRMN: What are the best tactics for educating physicians about managed care?
CS: We worked with a major health plan that was going to terminate 400 physicians who were losing money. We developed a managed care curriculum that educated physicians on CQI
(continued quality improvements), utilization management, risk management, disease management, reimbursement and alternative healthcare. The six-month program gave doctors a
common foundation to understand managed care and practice within its demands. By the end of the program, the HMO and physicians felt like they were a team. They have developed
boards and committees to keep the lines of communication open. What was once an adversarial relationship became a true partnership.
PHS can be reached at 303/973-4480 and http://www.phsolutions.org.