Practice Notes

The academic medical group, redesigned

by Hamza Hasan and Daniel Kuzmanovich

Academic medical centers (AMCs) are health care industry pillars known for advancing medical science and developing the next generation of physicians.

New report: How to redesign the academic physician group

But the academic mission doesn't shield AMCs from the financial pressures facing the rest of the health care industry. With high fixed costs and largely specialty-focused networks, AMCs must navigate significant challenges to respond to increased margin pressure, consumerism, and risk-based contracting. And, AMCs have the added dynamic of decreasing funding for both research and education. 

Faced with these trends, AMCs must adapt. Many are looking to their physician groups as the solution.  Modern AMCs need a physician group that can foster patient loyalty, perform care management tasks, and manage rising costs—all while maintaining their three-part mission of research, teaching, and clinical practice. 

To accomplish these goals, academic health systems across the country are using one or both of the below strategies to redesign their physician group.

1. Reengineer the faculty practice plan

AMCs rely heavily on their faculty practice plan to achieve the tripartite aim—research, education, clinical care. To respond to market pressure, AMCs are modernizing their faculty practice plan through three steps:

  • Physician segmentation based on primary mission: Instead of splitting their time across three missions, leading organizations ask their academic physicians to prioritize a single area of expertise;

  • Increased accountability for protected time: Leaders in academic health systems should closely monitor their physicians' non-clinical productivity to ensure they justify their protected time; and

  • Rightsized clinical productivity: AMCs increasingly invest in predominantly clinical faculty physicians to guarantee enough clinical revenue to cover the cost of the other missions.

2. Integrate employed non-academic physicians into the medical group

Another strategy AMCs can take to grow their clinical revenue is to employ non-faculty physicians to serve as a non-academic, community medical group dedicated to clinical care. But, as academic health systems invest in non-academic growth, they may find themselves with a new challenge: a divided physician group with infighting between academic and non-academic physicians based on cultural biases. Leading AMCs bridge the divide between academic and community physicians by:

  • Alleviating physician anxiety: Proactively reducing tensions between academic and non-academic physicians sets the stage for collaboration, ensuring physicians across the medical group are willing to work together;

  • Enabling physician collaboration: The best way to foster partnership between academic and non-academic physicians is to promote a partnership in pursuit of a goal more important than their differences—improving patient care; and

  • Developing unified leadership structures: Integrated physician governance that represents both academic and non-academic perspectives allows previously distinct groups of physicians to act as a single, cohesive medical group.
 

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