Doctors have a unique position within the healthcare system. Their relationship with patients is the highest value, and they have expertise, training, and a point-of-difference that other professionals can’t match. They are also a source of leverage for health systems in terms of access to capital and management resources.
The medical profession has evolved into a highly organized and disciplined group of professionals. These professionals are regulated by a variety of organizational structures and professional colleges depending on the provinces or territories, and their role in the delivery of medical services is defined through contracts with the government.
In Canada, a number of initiatives suggest that governments and the medical profession are exploring ways to involve doctors in health system improvement beyond their fundamental social contract and formal labour relations [2, 3]. These include: partnerships between medical doctors and hospitals or other public healthcare organizations; clinical leadership programs; and collaboration with other professionals on introducing new approaches to care.
One of the most common forms of physician organization is a group of physicians with different specialties. Such groups are often colocated together or relocated within a larger organization to provide care for a particular patient population, but they can be formed as individual units in a hospital or other health-care facility.
These structures are often designed to provide the physicians with a point of difference in the marketplace by bringing them closer together in order to increase performance and improve outcomes. The resulting organizations typically use care coordinators to assist physicians in achieving their goals. They also provide the coordination necessary to make sure that doctors and nurses work together effectively and communicate with each other.
The emergence of these organizational strategies is driven by the changing demands placed on physicians by government policies and market forces. For example, the shift toward value-based health care has created an environment where performance is important and doctors need to demonstrate their ability to lead and collaborate with other members of their team.
Traditionally, a physician’s job has been to treat patients and to ensure that their patients receive the right care in the best possible way. But now that health care is increasingly performance-driven, many physicians are embracing new ways of working and new types of relationships with patients, colleagues, and the systems they serve.
As a result, physicians are more likely to spend less time on the frontlines and more time working behind the scenes to help other members of their team deliver high-quality care. They are also incorporating their knowledge and skills in their role as clinical leaders, helping other professionals to introduce new practices and redesign the way care is delivered.
This approach has become popular with health-care providers, particularly those that are trying to improve patient outcomes. For example, Geisinger Health System in Pennsylvania has made a major commitment to putting its physicians in teams that coordinate their care with nurses. It has seen significant improvements in physician and patient satisfaction, as well as improved performance on key metrics such as readmissions and mortality rates.