Is Your Health Plan Hospital Controlled?

Is your plan a hospital controlled process or a plan sponsor controlled process?

It’s all about control…….He who controls the process wins.

“Hospital Systems Want to Employ Primary Care Physicians (PCPs) So They Can Drive PCP referrals to Their Own specialists – Who Will Then Order a lot of Tests and Procedures within Their Facilities.” – Eric Bricker, M.D.



My husband and I are on our way to Miami for a Christmas Medical School Reunion – 44 doctors and spouses almost all in their 70’s, and more than a few still working in their own private practices, and some who now share that practice with their physician children.

We were talking about the unintended consequences of employment for physicians and the hidden impact on physician workforce capacity.  There is a big difference between the capacity of a physician in private practice and the capacity of an employed physician.

In private practice, we worked to build/grow our practices the same way I work on our business now and probably the same way you worked to build/grow your business when you first started out as an independent consultant – i.e. we all worked harder and smarter than we did when we were employees.

That means we worked hard to be responsive to our referral sources, to consider the implications beyond the task at hand, and build responsive relationships with the other physicians and hospital staff we depended on to serve our mutual patients.

We worked long hours and we answered the phone in the middle of the night, and we left parties and dinners with family and friends to go to the ER even if it was just to be present with a long term patient while test results and possible emergency surgery were sorted out – because our presence meant something to the patient and family, and our physician colleagues, even if we were not clinically necessary or directly involved in the care needed at the time.

We were free to use the best of medical knowledge and medical judgement to apply protocols and quality standards to real people in the midst of real life, and depended on the quality of our relationships to keep us going.  We were judged against our own impossible standards, and thrived on the quiet gratitude of those with whom we shared the darkest moments of human existence.