Modernization and improvement of the healthcare system in any country is the process that never stops. However, medical facilities face a number of different challenges while trying to achieve the goal of developing efficient approaches to healthcare services. Before deciding where to move next, managers must have a good understanding of the current situation in a hospital. Moreover, they have to acquire information that provides the strategic decision-making process with appropriate data for analyzing past, present and future circumstances. One of the apparent difficulties surrounding this field is physician-hospital alignment. The reason for this is the complex relationship between clinics and doctors as they can be both partners and competitors. Therefore, researchers discuss several models that could help with overcoming this challenge.
One of such ways is implementing the integrated physician models. According to researchers, it is “a group of physicians and hospitals coming together to form a partnership to help aid in the improvement of quality patient care” (Harrison, 2016, p. 179). Liedtke et al. (2017) describe it as “a specific model of organization and cooperation of medical doctors which allocates tasks and defines roles differently for basic medical services and for specialized medical services within the hospital” (p. 31). This idea can be considered effective because physicians and other medical workers are implied to work together towards a specific achievement. This cooperation is conducted on multiple different ventures of a healthcare facility. The reason for its effectiveness is that it provides more manpower for reaching big goals, the accomplishment of which may be difficult for one organization. There is no doubt that in order for this idea to be efficient a group must ensure proper communication. In this case, the outcomes of the initiative would be the best. The integrated physician model is designed to allow various physicians to accomplish and meet goals for the patients and their treatment.
There are many defining elements of this model, which are defined by researchers. For example, Liedtke et al. (2017) also state that integrated units also perform the main functions regarding quality and productivity management. In addition, they are also engaged in protecting patients’ rights. The other types of facilities that use this model are medical coordination units. Their name suggests that they participate in delivering specialized health care in clinics. There are many examples of hospitals with an integrated physician mode, including cancer or primary care clinics, where doctors work together.
The importance of clinical integration in a strategic planning progress cannot be overestimated. It can ensure that physicians are capable of providing the best healthcare possible. It becomes achievable because “providers can track the patient across the continuum, coordinate care across the continuum and make sure the patient is getting the most appropriate care in the most appropriate environment” (Karash & Larson, 2016, p. 27). Furthermore, clinical integration guarantees the proper organization of care due to the improvement of the relationship between doctors and administrators. For this reason, there is an apparent need to facilitate the process of coordination between physicians and hospitals despite any circumstances.
The use of the planning function in the organization’s management creates other important advantages. For instance, strategic planning makes it possible to clarify emerging problems and make solutions. Moreover, it stimulates managers to implement their decisions in further work, as well as improves activities of employees of the organization. Furthermore, a strategy allows a hospital to create prerequisites for bettering the educational training and increases the ability to provide the organization with the necessary information. Another obvious benefit is that planning contributes to the rational distribution of the organization’s resources and improves control in the organization.
There is no doubt that a holistic approach should be taken when developing policies and strategies during the organizational process. Having physicians to be a part of the planning process is important because they are able to see firsthand how procedures and daily operations are performed. When doctors from different medical facilities communicate, it becomes easier to achieve a more cohesive treatment plan for a patient because the medical history can be more readily accessible.
A variety of different models of cooperation makes it difficult to pick one. That is why it is necessary to realize the risks and profits of each of them. Accountable care organizations (ACO) is one of the examples of such systems. However, some researchers seriously doubt the effectiveness of this type of collaboration. According to Colla et al. (2016), “ACO model has modest early benefits in terms of reduced spending and high-cost institutional use for patients with multiple clinical conditions” (p. 1174). The reason for this is that they put a heavy burden on doctors, which makes them unwilling to work. In addition, physicians who work at such facilities most often cannot acquire accurate critical data on high-risk patients. This disadvantage is due to the fact that most of the systems are engaged in enterprise analytics. This factor makes it difficult to assess necessary information that could improve the condition of patients.
Another important problem about ACOs is its inability to pay attention to behavioral and mental problems. They are not prepared enough to treat such patients, even though psychological problems have become some of the most important issues of today’s healthcare system. Moreover, despite its name, accountable care organizations often lack transparency, which makes it hard for physicians to take control of the processes. For the described above reasons, it would be safe to assume that ACOs cannot be considered efficient for improving collaboration between physicians and hospitals.
Nevertheless, aside from accountable care organizations, there is a wide variety of other models that can be beneficial for this issue. As an example, hospitalists are those people who “bridge the internal boundaries within their hospitals to coordinate their patients’ care, but they face challenges – scattered patients, fragmented information, uncoordinated teams” (Chesluk et al., 2015, p. 1). They handle the management of patient care during their hospital stay. This is work that used to be done by doctors with offices in residential areas.
Most of the hospitalists are physicians trained in the treatment of internal diseases, in other words, therapists. The rest were trained in family practice, pediatrics, and some other medical fields. They can also consult patients who require palliative care regarding pain and other symptoms. Typically, hospitalists are available 24 hours a day because they work in shifts. Their services can also benefit local hospitals. The reason for this is that local physicians with a strenuous work schedule may lack the time to manage the fast-paced and time-consuming patient care in the hospital. However, aside from advantages, there are also some difficulties, for example, issues in coordinating post-discharge care between hospitalists and treating physicians.
References
Chesluk, B., Bernabeo, E., Reddy, S., Lynn, L., Hess, B., Odhner, T., & Holmboe, E. (2015). How hospitalists work to pull healthcare teams together. Journal of Health Organization and Management, 29(7), 933-947.
Colla, C. H., Lewis, V. A., Kao, L.-S., O’Malley, A. J., Chang, C.-H., & Fisher, E. S. (2016). Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries. JAMA Internal Medicine, 176(8), 1167-1175.
Harrison, J. P. (2016). Essentials of strategic planning in healthcare (2nd ed.). Chicago, IL: Health Administration Press.
Karash, J. A., & Larson, L. (2016). Clinical integration managing across the care continuum. Hospitals & Health Networks, 90(6), 26-31.
Liedtke, D., Amgwerd, N., Wiesinger, O., Mauer, D., Westerhoff, C., & Pahls, S. (2017). The integrated-physician-model: Business model innovation in hospital management. In M. A. Pfannstiel & C. Rasche (Eds.), Service Business Model Innovation in Healthcare and Hospital Management (pp. 31-55). Cham, Switzerland: Springer.