Healthcare reform: our second chance
Written by Ardena L. Flippin, MD, MBA   

"Now is the time for us as physicians to realize that we are not only stakeholders in healthcare reform, we are being given the chance to take back leadership positions in our arena."

Alliances and accountability and stimulus money – Oh My!  All of these add up to healthcare reform.  Will physicians recognize impending reform as our chance to take back leadership positions in medicine?

Integrated healthcare systems (IHS) are fundamentally an employment model for physicians, one that combines hospitals and medical groups to deliver health care.  An apparent trend of physicians deciding to practice independent of community general hospitals and joining integrated health systems has the advantage of uniting the collective voices of physicians as well as providing the opportunity to be involved in executive management. 

According to Dan Zismer, “a fully integrated health system is one that employs most, if not all, physicians required to meet mission, strategic and financial goals.”  (The future of management education and training for physician leaders, Physician Executive, Nov 1, 2008).  Now is the time for us as physicians to realize that we are not only stakeholders in healthcare reform, we are being given the chance to take back leadership positions in our arena.

The IHS concept is not a new one and examples of successful high-profile models are Mayo Clinic, Cleveland Clinic, Kaiser Permanente and Geisinger Clinic in Pennsylvania.   Integrated health systems have the following pros and cons-

Pros of integrated health systems:

      • “More secure physician income and better physician “quality of life”” (Costs and benefits of integrated healthcare systems, Healthcare Financial Management, Tuesday, March 1, 1994)
      • Major focus on prevention and proactive health management
      • Cost effectiveness  is encouraged through innovation, efficiency, quality

Cons of integrated health systems:

  • Substantial investment, requiring large sources of capital (tens of millions of dollars)
  • Time-consuming endeavor that involves real estate transactions, purchase of assets, recruitment of primary care physicians, primary care network development, development of customized health information technology system and the development of a healthcare plan


So it seems that two types of physicians will be most desirable in reforming healthcare:  Primary care physicians as the “drivers”, and seasoned physician executives with appropriate health management education.   

Of course, the patients will have to do their part too and, as we know, preventive medicine strategies essentially means lifestyle changes

If integrated healthcare systems are models for national reform that will improve quality and lower cost, then we as physicians must develop an interest in the management of these centers.  We have allowed ourselves to remain back seat drivers in medicine for the past thirty years; it’s time for those of us with “skills” to step up and those who need to acquire management education skills to pursue the appropriate programs that will prepare us to assume our role as physician executives in the quest to deliver better care and reduce costs. 


Fischer, Elizabeth A.  Healthcare Financial Management, Tuesday, March 1, 1994

Zismer, Daniel K., Physician Executive, Nov 1, 2008.

About the Author

Dr. Ardena Flippin
Dr. Flippin brings a wealth of experience, starting with her long tenure as an attending physician at the Cook County Hospital Emergency Department. She is currently Corporate Compliance and HIPAA Privacy Officer at major Chicago hospital.

She is a keynote speaker focusing on the health care crisis facing corporations today (

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