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Physician Migration and Hospital Captives
Modifications to health care delivery are changing at a pace that far exceeds anyone's expectations ' and perhaps exceeds our ability to react and respond in a fashion that protects both provider and patient. One such modification is health care reform legislation, which will send a high number of previously uninsured patients to hospitals seeking care from a necessarily greater number of hospital-employed physicians. This trend will, in turn, alter professional liability exposures for the physicians who are migrating from private practice to hospital employment. It will also hasten the ongoing growth of hospital captives (hospital self-insurance) as a means of insuring physicians. Is this last a wise move?
The Changing Model: A Blip on the Radar, or Something More?
The increasing number of physicians becoming employed by hospitals and health systems has led to a rapidly shifting provider environment. Although some have drawn comparisons to a similar trend that occurred in the late 1990s, that
movement was later reversed because many physicians rejected the concept of direct hospital employment after fiercely feuding with hospital administrations. This latest shift toward direct hospital employment of physicians emerged again in 2009, shortly after federal health care reforms were enacted.
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