F.  MEDICAL GROUPS – MODELS

Status of Medical Groups in United States:

  • About three-fourths of doctors practice in groups of fewer than 10 and they are going to be under increasing pressure to obtain greater efficiencies and better outcomes
  • Some say that medical groups are no longer the model
  • Some say physicians will create “virtual groups” of physicians united by the Internet

About three-fourths of doctors practice in groups of fewer than 10 and they are going to be under increasing pressure to obtain greater efficiencies and better outcomes.

Some say that medical groups are no longer the model.  Back in Nixon administration in 1979, it was believed that prepaid care would encourage doctors to form groups to practice more efficiently like Mayo Clinic, Group Health Cooperative of Puget Sound, and Kaiser Permanente.  Consider the differences between forming groups to integrate medical practice as compared to be effective in negotiating with the insurance industry.

Paul M. Ellwood, president of the Jackson Hole Group and Interstudy states, “I don’t think the traditional multi-specialty practice has a very bright future,” says  because of the economic pressures on multi-specialty groups by managed care.  Ellwood’s solution is to form salaried primary care groups, each taking risk from a single HMO and contracting out for specialty services.  IPAs, are mainly negotiating entities in Ellwood’s opinion, that have little ability to coordinate or improve care.  Others disagree and foresees “virtual groups” of physicians united by the Internet.

Consider instead of having centralized affiliated medical groups having virtual clinics to balance economic incentives to deliver high-quality care in a cost-effective setting.  The virtual clinic is basically a network of independent medical providers connected through a central administrative core that provides efficient operation management using health care information through knowledge management.  Each practice in a virtual clinic maintains its own financial autonomy.

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