Now we need device makers and pharma to go to a retainer model, and research (especially basic research) to go back to the public sector.

practitioners?

I've never in life run across an unincorporated private practice.

This is better because of economies of scale and tying compensation to something other than direct interventions performed.

mega-hospital corporation.

I.e. the private practice doctor mentioned in the article is the head of his own company and has 1-4 employees.

More Details for Dr. Robert Morrow MD

Dr. Robert Morrow MD

A privately held company in Bronx, NY

Categorized under Family Practice Doctors, our records show it was established in 1980 and incorporated in New York, current estimates show this company has an annual revenue of $500,000 to $1 million and employs a staff of approximately 1 to 4.


http://www.manta.com/c/mmj6w0z/dr-robert-morrow-md


He sets the standard in his own practice and if he's going to squeeze labor, it's his own. OTOH, if you're a salaried employee physician of this corporation:

Hospital Corporation of America (HCA) is an American for-profit operator of health care facilities, the largest in the world.[1] It is based in Nashville, Tennessee and currently manages 162 hospitals and 113 freestanding surgery centers in the United States and United Kingdom.[2]

http://en.wikipedia.org/wiki/Hospital_Corporation_of_America


things are different.

FYI, not all private medical practices are organized as corporations, albeit you may have never seen it.

A limited liability company (LLC) is a flexible form of enterprise that blends elements of partnership and corporate structures. An LLC is not a corporation; it is a legal form of company that provides limited liability to its owners in the vast majority of United States jurisdictions. LLCs do not need to be organized for profit.[citation needed] Certain types of businesses that provide professional services requiring a state professional license, such as legal or medical services, may not form an LLC but use a very similar form called a Professional Limited Liability Company (PLLC).

http://en.wikipedia.org/wiki/Limited_liability_company

http://pplpho.org/

My daughter's orthodontist uses a salary-based approach.

Also, he does package pricing rather than fee for service.

corporation?

... my point is that salaries are better for health care, but that doesn't mean taking a corporate route necessarily. Having said that, he runs a small business, so it is a "corporation" at some level.

It will make things worse.

My friend's practice recently jumped on board a hospital. They are all happy because they got a big raise from what the partners were paying themselves.

Now they have to produce revenue for the hospital by admitting patients.

Why do you think Halliburton bills time & materials rather than fixed price?

My friend has a quota.

I can imagine a point where hospital admissions have to be manufactured, but I don't think we're there yet.

That said, not all salaried health positions are in the "large hospital" model; some are in the "small clinic" model, particularly the excellent Federally Qualified Health Clinic model, which receives Federal subsidies through the ACA and in return charges patients on a sliding scale. It's frankly the best part of ACA, and the reason Senator Sanders supported the bill.

Doctors are like most folks.. They want a guarantee. They have regular bills to pay and need a regular defined income to rely upon.

I don;t think it makes much difference to most patients.. They just want to see a doctor when they are ill..

It makes sense for doctors to use the medial tools provided by a hospital/large clinic.

Anyone who has ever been to Mayo Clinic knows how effective it is when doctors are NOT "on their own". You get a much better quality of care when doctors can just concentrate on medicine

I work for a non profit healthcare system, we have our own docs. My outpatient provider loves it, he has a fixed work schedule, the healthcare system pays his insurance, they foot the bill for the office, staff and equipment, he's never on call, off all holidays and weekends, when I get admitted as an inpatient then one of the hospitalists takes over my care, our computer system is top notch so all my doctors have access to my records.
As an employee,it makes my job easier to be able to access the patients records from all encounters even if it is not related to their acute diagnosis. Cuts down on repeat tests and consults. The other thing is I don't see how this is going to drum up admissions, if anything aca especially with mcare changes is going to cut back on reimbursements if care does not meet outcomes or if the same people keep getting admitted, where I work we have been working on a 2 year research project that identifies our frequent flyers to reduce the number of admits to acute care, mcare is going to punish us if we have readmits within 30 days for the same diagnosis, this is a big deal and forces the emphasis on more aggressive discharge planning and outpatient care.

be squeezed for profit and their practice will be dictated by bean counters.

"The bourgeoisie has stripped of its halo every occupation hitherto honoured and looked up to with reverent awe. It has converted the physician, the lawyer, the priest, the poet, the man of science, into its paid wage labourers".