HealthDay News — Based on a study in the Annals of Internal Medicine, there was no impact on primary composite quality metrics since hospitals have been increasingly switching to an employment relationship with physicians.

Kristin Scott, MPhil, PhD, from Harvard TH Chan School of Public Health in Boston, and colleagues conducted a retrospective cohort study of US acute care hospitals between 2003 and 2012 to examine changes in hospitals that reported employment relationship with their physicians. Data were included for 803 switching hospitals and 2085 non-switching control hospitals, matched for year and region.

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The researchers found that approximately 29% of hospitals employed members of their physician workforce in 2003, which increased to 42% by 2012. Switching hospitals were more likely to be large or major teaching hospitals, and were less likely to be for-profit institutions, relative to regionally matched controls (all P<.001). 

There was no correlation between switching to an employment model and improvement in any of 4 composite quality metrics up to 2 years after conversion.

“During the past decade, hospitals have increasingly become employers of physicians,” the authors write. “The study’s findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.”

One author disclosed financial ties to the pharmaceutical and health care industries.


Scott KW, Orav EJ, Cutler DM, Jha AK. Changes in Hospital–Physician Affiliations in U.S. Hospitals and Their Effect on Quality of Care. Ann Intern Med. 2016 September 20. doi:10.7326/M16-0125. [Epub ahead of print]

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