ABSTRACT

Employment seems to be the model of choice right now. That is probably because it has none of the issues that are present with the other models. The practice is purchased, and the doctors go to work for the health system. There is money up front for the physicians, and they sidestep future risk except for the risk of working for a hospital, which is certainly not risk-free, but it is at least a risk that is defined in a contract. The hospital gains an integral part of its medical staff complement in a form that is pretty dependable, and it is a form that has fewer compliance issues and lower overall maintenance (at least as far as governance is concerned). The doctor is often able to free capital from the practice that can be put to use now and be released from long-term debt in an uncertain business environment. Generally, both parties can complete the transactions involved without the tedious negotiations and external considerations that group formation (independent provider associations (IPAs), physician-hospital organizations (PHOs), management services organizations (MSOs)) would demand.