Although the Affordable Care Act opened the door for hospitals to contract with physicians, the power imbalance between the two entities may not always favor the physician, said John Prunskis, MD, Illinois Pain & Spine Institute CEO and medical director.
The ACA accelerated physician employment by hospitals, and often they could pay physicians more compared to an ASC. While the higher salary may be attractive, Dr. Prunskis said physicians should be wary of hospital policies that may influence referrals.
"Hospital employed physicians need to have in writing assurances that they will not be pressured to refer to specialists within the same hospital network," Dr. Prunskis said. "Such forced referrals compromise the trust between a patient and doctor in that the hospital employed doctor may not be recommending a specialist who is best, however, is compelled to choose from a roster of those physicians employed by the same hospital system."
Dr. Prunskis also said managing electronic health records, a requirement for hospitals, may put undue stress on physicians. EHRs are a top cause of physician burnout, he said.
"Physicians in private practice are not forced to use EHRs and can develop better, more efficient systems enhancing the healthcare of their patients and wellbeing of the physicians," he said.
Those looking to change their work should consider other options, Dr. Prunskis said.
"There are alternatives for physicians to hospital employment such as physicians joining a larger consortium of quality physicians that are not employed by hospitals," he said. "Unless they have no other choice, I would advise physicians, especially in my specialty of interventional pain management, to steer clear of hospital employment."