Hospital partnerships come with benefits and tradeoffs for spine surgeons. Knowing how to approach these contracts can help physicians find their best match.
Two spine surgeons discuss their strategies.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all spine surgeon and specialist responses.
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Editor’s note: Responses were lightly edited for clarity and length.
Question: How should spine surgeons consider and approach hospital partnership decisions?
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): With balance and intent.
At face value, partnering with a large healthcare organization offers clear benefits: access to a more advanced infrastructure, systemwide innovation, and the potential to impact population-level health through enterprise/medical system-level initiatives. But, like most major decisions, understand the possible tradeoffs: bureaucratic layers, loss of autonomy, and a push for over-standardization (risk of being treated more like a commodity).
For me, there are three main factors:
1. Understand the strategic vision: Is the system built to succeed in a changing era of health economic transformation, where resource stewardship, affordability, and financial sustainability are both operational and clinical concerns? I would look for alignment (more than just the mission) in how the system is preparing for the pressures of rising costs, changing reimbursement models, and the shift toward care that balances outcomes, experience, and economics.
2. Assess the ability to actually execute: Are front-line voices heard in major initiatives? Will your time be spent on patients … or navigating new workflows, committees, and approval processes? How are decisions made?
3. Think long-term impact: Can this partnership actually improve (and ultimately amplify) your ability to serve more patients, shape care models, and lead change from within?
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Contract and expectation dependence will drive what spine surgeons desire in a formal contractual agreement with business partnership of any kind. The usual litany of roles, profit sharing, operational decisions, liability, insurance as well as termination and non-compete clauses must be settled with meticulousness and mutual consent. Amongst other listed awkwardnesses, is conflict resolution through mediation so litigation can be avoided at all cost.
