Stamy Chris D, Schwartz Christine C, Han Lin Po, Schwinn Debra A
Roy J. & Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Department of Anesthesia, Roy J. & Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Mayo Clin Proc Innov Qual Outcomes. 2021 Sep 21;5(5):951-960. doi: 10.1016/j.mayocpiqo.2021.06.008. eCollection 2021 Oct.
To examine best practices and policies for effectively merging community and academic physicians in integrated health care systems.
Deans of US allopathic medical schools were systematically interviewed between February and June 2017 regarding growth in their faculty practice plan (FPP), including logistics and best practices for integration of community physicians.
The survey was completed by 107 of 143 (74.8) of US medical school deans approached. Of these institutions, 73 met criteria for final analysis (research-based medical schools with FPPs of >300 physicians). Most academic medical center-based FPPs have increased in size over the last 5 years, with further growth anticipated via adding community physicians (85%). Because of disparate practice locations, integration of community and academic physicians has been slow. When fully integrated, community physicians predominantly have a clinical role with productivity incentives. Deans report that cultural issues must be addressed to avoid conflict. Consensus exists that transparent clinical work requirements for all FPP members, clearly defined productivity incentives, additional promotion tracks, and early involvement of department chairs and other leaders enhances trust and creates better synergy among all physician providers.
Findings from this study should help guide FPPs, academic medical center leaders, chief medical officers, and professional and trade organizations in working toward positive physician synergy in consolidated health care organizations. Work and cultural considerations must be addressed to honor distinct talents of each physician group, facilitating smooth transition from disparate groups to healthy synergy.
探讨在综合医疗体系中有效融合社区医生和学术型医生的最佳实践与政策。
2017年2月至6月期间,对美国所有opathic医学院的院长进行了系统访谈,内容涉及他们的教师执业计划(FPP)的增长情况,包括社区医生整合的后勤保障和最佳实践。
在143名受访的美国医学院院长中,有107名(74.8%)完成了调查。在这些机构中,73家符合最终分析标准(基于研究的医学院,FPP的医生人数超过300人)。在过去5年中,大多数学术医疗中心的FPP规模有所扩大,预计通过增加社区医生将进一步增长(85%)。由于执业地点不同,社区医生和学术型医生的整合进展缓慢。完全整合后,社区医生主要承担临床角色,并设有生产力激励措施。院长们报告称,必须解决文化问题以避免冲突。大家一致认为,为所有FPP成员制定透明的临床工作要求、明确界定生产力激励措施、增设晋升渠道,以及部门主任和其他领导者的早期参与,能够增强信任并在所有医生提供者之间创造更好的协同效应。
本研究的结果应有助于指导FPP、学术医疗中心领导、首席医疗官以及专业和行业组织,在整合后的医疗保健组织中实现积极的医生协同效应。必须考虑工作和文化因素,以尊重每个医生群体的独特才能,促进从不同群体向健康协同的平稳过渡。