Physicians examine patient
photo credit: Seattle Municipal Archives

For the past 20 years California hospitals have experimented with directly employing physicians - bypassing the traditional method of a private practice doctor with admission privileges.

Now North Bay state assembly member Jim Wood is hoping to make that experiment permanent for California’s rural hospitals, Cathy Mudge said.

"Typically a physician who works in a large hospital system, they own their own private practice and they work at the hospital occasionally," Mudge said.

Mudge, Wood’s communication director, said Wood’s latest bill would make a 2016 pilot program permanent, allowing certain hospitals to directly employ physicians.

Mudge said the goal is to keep essential care within the community.

"We believe that it's an incentive to get physicians into some of these smaller hospitals who otherwise wouldn't locate in those remote areas because opening a private practice in a smaller, lower populated area is financially challenging because they just don't have the volume," Mudge said.

Critical access hospitals are federally defined as small hospitals with 25 or fewer beds located in remote or rural areas.

Mudge said the bill mainly focuses on improving healthcare access to under served communities, struggling to maintain healthcare services. The bill also aims to meet the changing attitudes of the newest generation of physicians.

"Some of the younger physicians don't want to open a private practice anymore," Mudge said. "They don't want to run a business, they want to practice medicine."

"A lot of the new physicians coming out of medical school would much prefer to be an employee, have their time spent caring for patients and not doing business related activities," Mudge said.

One of the main concerns over the direct employment of physicians, Mudge said, is over the autonomy of physicians to make treatment decisions for their patients.

"That, say, the critical access hospital would tell them how to treat patients, but that has not been the case," Mudge said.

Wood said the success of the pilot in California, and similar programs in other states, has shown that “the sky will not fall” when hospitals directly employ physicians.