Opinions about Healthcare Consolidation
Physician and Advanced Practitioners weigh in on Healthcare Mergers and Acquisitions
Mergers and acquisitions have been especially prevalent in the healthcare industry over the past few years. In our 2019 LocumTenens.com Compensation and Employment report, 41% of physicians and advanced practitioners disclosed they had been employed at an organization where there was a merger or acquisition. The motivation behind these types of healthcare consolidations typically involves a combination of the following: improving quality of care for patients and making additional resources and expertise available to staff, all while reducing costs.
In an ideal world, consolidation would bring these elements to fruition without negatively affecting a facility's operations or its clinicians. And while many facilities are reporting that consolidation has brought about nothing but positive outcomes for the populations they serve, the effect consolidation has on healthcare providers has been largely unexplored.
More than 41% of clinicians acknowledged that consolidation brought their organization increased access to additional resources, technology and expertise. As a Nurse Practitioner Neurologist elaborates, "it helps patients, as we will now have specialties we didn't previously have, so patients don't have to travel so far."
However, when asked if they felt valued by the larger organization post consolidation, a staggering 48% of providers indicated they disagreed, with 27% of these respondents strongly disagreeing. "There is a loss of culture and a lack of genuine care of employees," comments an Ophthalmologist.
When employees in any profession don't feel valued, it can lead to decreased job performance, but when healthcare providers don't feel valued, it can easily lead to burnout, which means decreased quality of care for patients. In fact, 62% of physicians and advanced practitioners disagreed that consolidation benefitted quality of patient care. Without the buy-in of the medical staff, the intended benefits of consolidation are not likely to be realized. One Hospitalist finds "it leads to fewer choices of physicians (out of network) and increased confusion about patient bills or appropriate contact people for information."
A successful healthcare facility has a strong culture and weaves elements of that culture into every aspect of care, including the way it cares for its physicians. However, when it comes to valuing shared culture, 39% of physicians surveyed indicated that they disagreed that leadership paid specific attention to a placed value on the shared cultures of the consolidating organizations, and of that 39%, almost 20% strongly disagreed with the statement. Demonstrating value of shared culture is one of the biggest opportunities for stakeholders to garner buy-in from providers and ensure they feel valued, and, unfortunately, it's an opportunity that's often missed.
Efficiency of operations is often cited as a motivating factor for consolidations, but how efficiently two facilities become unified can get in the way of clinicians' perceptions of how efficiently a facility runs: only 20% of physicians felt that consolidation has made their organization more efficient. Although high-level decisions are often out of facility administrators' hands, the day-to-day operating strategy isn't, and day-to-day decisions are the ones that end up coming together to make the biggest impact on providers.
Have you ever been employed at a facility where there was a merger or acquisition?
42%
Yes
52%
No
6%
Unsure
Due to the merger or acquisition, were any members of the medical staff laid off?
48%
Yes
36%
No
16%
Unsure
Due to the merger or acquisition, how were you affected by the layoff?
How long did it take to integrate and unify the facilities involved in the new partnership?
"It helps patients as we will now have specialties we didn't previously have, so patients don't have to travel so far" -NP Neurologist from Northeast
In my experience with healthcare consolidation, the cost of care for our patients has decreased.
14%
Yes
43%
No
43%
Unsure
In my experience with healthcare consolidation, the quality of care we provide has increased.
23%
Yes
35%
No
42%
Unsure
"It leads to fewer choices of physicians (out of network) and increased confusion about patient bills or appropriate contact people for information" - Hospitalist from Southwest
In my experience with healthcare consolidation, my hospital or practice has gained access to additional resources, technology and expertise.
42%
Yes
19%
No
39%
Unsure
Post consolidation, we've become more efficient as an organization.
20%
Yes
36%
No
44%
Unsure
In my consolidation experience, our leaders paid specific attention to and placed value on shared culture.
19%
Yes
39%
No
42%
Unsure
Post consolidation, I feel I am valued by the larger organization.
14%
Yes
48%
No
38%
Unsure
"There is a loss of culture and a lack of genuine care of employees" - Ophthalmologist from the southeast
Methodology
Invitations for the survey were emailed to a database of more than 150,000 healthcare professionals in August 2019. Some recipients had been placed by LocumTenens.com, and some had not. There was a total of 3,580 respondents, both physicians and advanced practitioners, who were self-selected and spanned all 50 states. Physician respondents included those from 15 medical/surgical specialties: radiology; psychiatry; family practice; critical care; neurology; obstetrics/gynecology; pediatrics; anesthesiology; general surgery; orthopedic surgery; urology; cardiology; hospitalist; internal medicine; and emergency medicine. Advanced practitioner respondents included those from eight medical specialties: emergency medicine physician assistants; primary care physician assistants; critical care nurse practitioners; psychiatric nurse practitioners; emergency medicine nurse practitioners; primary care nurse practitioners; hospitalist nurse practitioners; and CRNAs.
