Envisioning Future of Physician Leader of Medical Group Practice Health care industry to get financial and management praises are also adopting the strategies of retail giants Wal-Mart, Google and Amazon. A research study have suggested that merely 3% of American physicians are in regular contact with their patients through emails or whatever means and one fifth of Medicare recipients that had visited hospital will end up back at the hospital within a month or even less. It was found through research that this figure of high frequency of repeat patients can be reduced drastically if doctor or nurse followed up with the patients after checking them. Doctors or nurses don't bother to follow up with the patient after reasonable time of their check up like a week because they don't find any incentive in doing so (Nobel, 2011).

The management and organizational structure of hospital is as important as any other profit or not for profit organization. Management and executive committee use strategic management information for corporate planning by clarifying objectives; applying the tools like gap analysis to evaluate the strategies and objectives performance; make strategic decisions within the parameters of sustainability, acceptability and feasibility and setting up the control mechanism to evaluate the progress towards objectives. Like other private for profit commercial and business enterprises in hospital management as well planning and control are often termed as distinct processes. Planning is concerned with identifying where the organization wants to be which is devised in corporate objectives and how will it get there which is devised in strategies. The control activities are concerned with monitoring achievement of objectives and suggesting corrective action plan that might include alteration of the objectives. Management control also measures that resources are obtained and utilized effectively and efficiently. It is critical for the management committee of the organization to decide what organization structure would be appropriate for medical group practice.

Organizational structure for medical group practice

There are numerous frameworks of organization currently in the field, including single-specialty groups, multi-specialty groups, academic medical centers, community health care centers, risk-bearing comprehensive care organizations (such as Kaiser-Permanente), and government-based medical organizations such as the VA system or the Indian Health Service. Organizational management is a long-term, planned organization wide effort that is managed from top to bottom with the aim of improving organization effectiveness and health by using behavioral sciences techniques to intervene in the process of management. To incorporate change that will augment organization effectiveness and health, change agents must be working with the internal and external environmental influences and are able to analyze and improve the working relationships among organization members (Beer and Elise, 1989). The critical success point to the effectiveness and growth of these organizations is dynamic leadership, technical expertise, human relations and conceptual skills that compel the organization to sustainable development (Edwards, Richard L. And John A. Yankey, 2006).

The objectives and goals of the hospital are quite different from that of the for-profit business entities. Hospitals are not profit oriented they are developed for community service and health management. Hospital seeks to offer the best possible care to as many patients as possible depending on the budgetary constraints. The future of the medical group practice based on the nature of the organizational setup cannot be viewed as single structure. It is the combination of activities and organized delivery of care. The industry benchmarking the standardized practice could also not be possibly achieved because it is a challenge for each health care setup to achieve their mission while envisioning the future of physician leader of medical group; this is in actual terms the concept of healthcare management leadership. The quality structure of the hospital management depends on its capacity to deliver care, which is established on the qualifications of the practitioners, the nature of services and facilities and other organizational factors. The structure measure of the organization comprise of services, size, location, licensure and accreditation status and other physical characteristics such as working environment (National...

If health care specialize in these two areas it will be able to achieve efficient heath care delivery system. While doing so numbers of organizational structures have been suggested for physician leaders to practice in the health care industry.
These include multi-specialty group practice, voluntary staff model and specialized facilities.

Voluntary Medical Staff Model: Conventionally community hospitals have been the center of physician's workplace. These hospitals have provided equipment and staff that made possible for physicians to practice and provide services which were not readily available if they practice in their independent offices. For providing this service physicians agree to serve without compensation on medical staff committee and agreed to share on-call responsibilities for emergency department for patients who need consultation or admission or both. Many physicians consider these responsibilities as their contribution towards society and take it as a pride in their local hospitals and professional ethics in providing health care that needed. However, the generous pay rates offered by the hospitals made physicians willing to accept employment by the private and local hospitals which creates down turn in the voluntary medical staff model (Lawrence P, 2008).

The vision of voluntary medical staff model can be applied for the future of physician leader in a way that the newly graduated physicians avail the opportunity of gaining experience in their service delivery through these community health centers. The industry well-known and experienced physicians should be motivated to spare some time on this service and act as a support to the young physicians. This way practical training structure would be setup for the physicians through voluntary model which will augment their skills and aptitude.

Multi-specialty group practices: The medical care provided by the large integrated multi-specialty group practice was of better cost and quality. Research have shown that beneficiary of multi-specialty group practice registered with the Council of Accountable Physician Practices (CAPP) where from wide geographic location have demographics of young and male living in low income localities with different socio-economic situation as compared to multi-specialty group not registered with CAPP. The advantage of multispecialty group register with CAPP is that beneficiaries have to face with cost much lesser as compared to the case with non-CAPP associates. The fee structure for multispecialty group was focused with higher quality with lowest possible cost (William B, 2010).

The strategic implication of this kind of service delivery is that many physicians who function in their own independent setup which is physically small and not wide in its outreach need to develop associations with other physicians and for their network. The multispecialty groups will advantage its beneficiary with cost, better quality, wide range of service delivery, flexibility and service delivery outreach covering large market segment.

Physician Owned-Specialty: Hospitals and health care units through dedicated staff, equipment and management control to treat a single specific disease will create cost benefit, high level of service delivery and increased patient satisfaction in both inpatient-specialty hospitals and outpatient-ambulatory surgery centers. Specialized facility by the physician is attractive to them since it enables physicians to collect fees for their professional service and share the portion of it with the hospital. This fee was traditionally has gone completely to the hospitals. Health plans are now more focused with customized service delivery, optimum resource management and better mitigation of risk. Hospitals operating in close proximity have increased the probability of generating more revenues.

The future growth of specialty group is that large scale specialty group can establish hospitals themselves. But the creating of specialty hospital is more likely in areas where there is no big brand of hospital operating. This is rather an opportunity for specialty hospital to serve the market where big names are not reaching. They will not be directly confronted with the competition.

CONCLUSION

The…