When Physicians are Owners AND Employees

January 4, 2018

The professional model of medicine is trying to reach a sweet spot, allowing physicians to remain independent but maximize the power of a larger organization.

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The way Holston Medical Group President and CEO Scott Fowler, MD looks at it, physicians in his organization are both owne[[{"type":"media","view_mode":"media_crop","fid":"64969","attributes":{"alt":"","class":"media-image media-image-right","height":"224","id":"media_crop_8112887235195","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"8318","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right;","title":"Scott Fowler, MD","typeof":"foaf:Image","width":"149"}}]]rs and employees.

"Revenue cycle is centralized. A lot of the economies of scale and business functions are centralized…but it still recognizes the inherent value of having the physician being an owner in a group practice," Fowler says in the podcast.

The professional model of medicine, as he calls it, is not a confederation. And unlike an IPA, Holston Medical Group is a centralized company. In that sense, physicians do answer to a central hierarchy and adhere to its standards. However, unlike a traditional medical group, physicians recruited to join Holston automatically become owners and have a say in the overall direction of the organization.

"Once you are in Holston, you are an equal owner….you're part of that partnership of peers that make up a professional organization. Inside of that, you're the captain of the ship for the pieces in the puzzle you deal with."

Later in the podcast, Fowler talks about the challenges Holston Medical Group faces in recruiting young physicians to join the professional model, rather than a large health system in terms of income and scheduling. He says that while the latter can often offer a higher income because of their non-profit status, Holston allows physicians to profit as owners when the group does well financially. And while it doesn't offer a fixed schedule, being a part of the professional model "isn't about showing up from 9 to 5…we think it's a more satisfying model, less burnout."

Fowler also talks about some of the investments the medical group has made to stay relevant in IT infrastructure. These investments, he says, allow Holston to succeed in a value-based environment.

"To succeed in those contracts you have to have great relationships with your patients, they have to be engaged, doctors have to have data at the point of care. That is what sets [Holton] apart. Most independent practices can be a little [quicker] on their feet to adopt these new ideas," Fowler says.