Hospitals increasingly employing doctors, effects on care uncertain

(HealthDay)—Hospitals are increasingly switching to an employment relationship with physicians, but switching has had no impact on primary composite quality metrics, according to a study published online Sept. 20 in the Annals of Internal Medicine.

Kristin W. Scott, M.Phil., Ph.D., from Harvard T.H. Chan School of Public Health in Boston, and colleagues conducted a retrospective cohort study of U.S. 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 2,085 non-switching control hospitals, matched for year and region.

The researchers found that approximately 29 percent of hospitals employed members of their physician workforce in 2003, which increased to 42 percent 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 < 0.001). There was no correlation between switching to an employment model and improvement in any of four composite quality metrics up to two 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.

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