Physicians have felt the earth move under their feet.
And after years of almost constant change, conflict and even chaos, many physicians are adapting to the new order of healthcare.
Hospitals and health systems should use this period of adjustment to reassure their doctors that they are willing and able to strengthen the ties that bind them.
In many ways, the relationship between hospital management and medical staffs is similar to that of parents and teen-agers. Like parents, hospital managers have important fiscal and supervisory powers. They admire and respect physicians and are proud of their accomplishments.
Yet communication between the two is poor. Physicians, like teen-agers, sometimes resent following rules and often complain that administrators don't understand them. But at a time of crisis or trouble, they often turn to management. This "help us, leave us alone" yo-yo makes for trying and tumultuous times.
Physician income and power have been threatened by managed care and government payment policies. In response, doctors have sold their practices to physician management companies or health systems. But most of those ventures have collapsed or are threatening to.
So it's back to the basics. Now is an appropriate time to create a new strategy to rebuild the hospital-physician bond. That may require fine-tuning the existing course of action or a revolutionary change in attitude.
Fortunately, things could be worse. A few years ago physicians feared major income erosion. Instead, salaries have stabilized. Our annual physician income survey, which appeared in the Aug. 7 issue (p. 37), showed salary increases are not as high as in previous years, but neither are the decreases.
Still, physicians want the opportunity to earn more money and respect for participating in organizational initiatives. They should be rewarded for active participation in quality and cost-reduction efforts. Hospital managers, like parents, need to encourage and give incentive to their charges to accept new responsibilities.
The goal is to rally physicians and executives around the three themes of improved patient satisfaction, cost-effective treatment and high quality outcomes.