Community and Academic Physicians Working Together in Integrated Health Care Systems

Abstract

Objective: To examine best practices and policies for effectively merging community and academic physicians in integrated health care systems. Methods: Deans of US allopathic medical schools were systematically interviewed between February and June 2017 regarding growth in their faculty practice plan (FPP), including logistics and best practices for integration of community physicians. Results: The survey was completed by 107 of 143 (74.8) of US medical school deans approached. Of these institutions, 73 met criteria for final analysis (research-based medical schools with FPPs of >300 physicians). Most academic medical centerebased FPPs have increased in size over the last 5 years, with further growth anticipated via adding community physicians (85%). Because of disparate practice locations, integration of community and academic physicians has been slow. When fully integrated, community physicians predominantly have a clinical role with productivity incentives. Deans report that cultural issues must be addressed to avoid conflict. Consensus exists that transparent clinical work requirements for all FPP members, clearly defined productivity incentives, additional promotion tracks, and early involvement of department chairs and other leaders enhances trust and creates better synergy among all physician providers. Conclusion: Findings from this study should help guide FPPs, academic medical center leaders, chief medical officers, and professional and trade organizations in working toward positive physician synergy in consolidated health care organizations. Work and cultural considerations must be addressed to honor distinct talents of each physician group, facilitating smooth transition from disparate groups to healthy synergy.

Department of Medicine 2040: Implementing a Constrained Disorder Principle-Based Second-Generation Artificial Intelligence System for Improved Patient Outcomes in the Department of Internal Medicine

“… 22 - 24 Expanding the partnerships between departments of medicine and community physicians is required. 25 …”

“…[22][23][24] Expanding the partnerships between departments of medicine and community physicians is required. 25 As a result of their inherently conservative nature, healthcare systems are hard-pressed to adapt to changes relating to costs and how to harness doctors to do so. The way medicine departments operate in many parts of the Western world is similar to how they did 2 or 3 decades ago.…”

The Academic Learning Health System: A Framework for Integrating the Multiple Missions of Academic Medical Centers

“…Third, many AMCs are creating larger integrated delivery systems to engage more effectively in risk-based contracting, support population health initiatives, leverage relationships with commercial payers, and garner economies of scale. 48 , 49 While such integrations provide new opportunities for large-scale clinical and health care delivery research, they may bring together organizations with different cultures and priorities, particularly with regard to research and education. 48 Tensions may further heighten when integrations include AMCs as a smaller partner.…”

“… 48 , 49 While such integrations provide new opportunities for large-scale clinical and health care delivery research, they may bring together organizations with different cultures and priorities, particularly with regard to research and education. 48 Tensions may further heighten when integrations include AMCs as a smaller partner. Thus, the future success of an aLHS depends on its ability to garner support among a broad range of collaborators and demonstrate the value of the aLHS framework for improving clinical, operational, and financial metrics and differentiating AMCs in health care markets.…”

Outcomes of Antineoplastic Immunotherapy at a Large Healthcare Organization: Impact of Provider, Race and Socioeconomic Status

“… 34 , 35 The model of full-spectrum health-care organizations offering primary through quaternary care often involves an academic medical center with their faculty and community practice physicians. 36 The resulting interface between providers with different scopes of practice has the potential to further promote the delivery of evidence-based, high-quality oncology care to patients closer to home. For instance, combined community and academic virtual tumor boards have the potential to offer COPs the opportunity to obtain a multidisciplinary review of their challenging cases within a convenient platform.…”