I had an interesting visit yesterday from a WMHS Advisory Board member. At WMHS, we encourage our Advisory Board members to seek us out to offer their perspective on the health system, especially about how we are being viewed in the community. His concern was that we are driving physicians out of the Health System and, subsequently, the community. He gave some examples of physicians who have left or recently announced that they are leaving. I was able to explain the reasons why each left the organization and their stated reasons were not related to the health system, except for one. We tried to keep that physician in the community, but we were unsuccessful. So, in that case one could say that physician felt that he was being driven out. Also, in each case, we have been able to successfully recruit replacements for each of the departing physicians.
The board member then asked questions regarding what we are "now" requiring physicians to do in order to admit patients, perform surgeries, order tests, etc., implying that our requirements are extremely onerous and unnecessary. I explained that hospitals are held accountable for compliance with over 122,000 federal regulations. In addition, each payor has its own set of requirements to which we must comply in order to get paid. And on top of that, there are state laws and regulations for which we are responsible. This is why Peter Drucker, the management guru, says that health care is the most difficult industry to manage.
The board member also said that the new payment methodology, Total Patient Revenue, is not being embraced by the physicians. That gave me the opportunity to explain that TPR will be the only way in which all hospitals across the US, as well as physicians, will be paid in the next few years. WMHS was able to participate in a demonstration project and get the opportunity to learn how to apply a value- based payment methodology over the more costly volume-based methodology.