Q&A

The Value of the Physician Ownership Model

With so many types of healthcare companies out there, it can be confusing to understand the models for physician ownership. Two Vituity Partners break down what it really means to be an owner in a democratic group, and how that impacts your practice and career.

Payton McGowen , MD

Board Member

Sachin Patel , MD, MPH

Board Member

Published September 17, 2020

To demystify the experience of ownership, we sat down with two Vituity Partners. Payton McGowen, MD, is a hospitalist medical director in Illinois and an elected member of the Vituity board of directors. Sachin Patel, MD, currently serves as an emergency medicine regional director for the Midwest region.

Ownership. To many physicians, it’s a foreign concept. Most of us trained at academic medical centers where employment was the norm. And the newest generation of physicians is increasingly choosing employment over independent practice. We'll be honest: Vituity doesn't fit this mold.

Fifty years ago, our founders created a great place to practice medicine, knowing that empowered clinicians deliver the best care. Today, we’re a growing partnership of 3,300 physician owners serving 8,000,000 patients annually nationwide. An astounding 90% of physicians who join us, make Vituity their long-term practice home.

Q: First off, how would you explain physician ownership as a physician group practice model to someone who has never experienced it?

Payton McGowen (PM): When I think about ownership, the word that comes to mind is empowerment. As physician owners, we each have a say in how we run our practice and care for patients. Everyone from the medical director to the newest attending has a voice.

Sachin Patel (SP): To me, ownership means I succeed when our practice succeeds. We each have a direct stake in the quality of our care and a voice in how we deliver it. This energizes us to solve problems, innovate, and work as a team.

Q: Tell us about your career paths before joining Vituity.

SP: After residency, I worked for several emergency medicine groups as both a physician and clinical leader. One of my best friends had joined Vituity right out of residency, and through him, I grew to admire its culture and values. Because I didn’t live near a Vituity emergency room, I joined as a reservist, which is a travel position that supports new practices. In addition to bringing clinical expertise and physician leadership, reservists also act as cultural ambassadors. So, it was a great way to dive into ownership headfirst.

PM: After residency, I was employed for nine months before our hospital decided to bring Vituity in to manage the hospitalist service. At that time, I’d never realized a physician-owned partnership was an option for hospitalists. The ideas of democracy, transparency, and running our own practice greatly appealed to me as well. I guess others felt the same way, because our entire group joined Vituity.

At Vituity, not only are our values of democracy, transparency, autonomy, and servant leadership stated upfront, they’re woven into our everyday practice.

— Sachin Patel, MD
Regional Director

Q: When you became a Vituity Partner, were there cultural markers that stood out to you with this physician group?

PM: Financial transparency was a big one. As soon as we joined Vituity, the books opened, and we knew what everyone else was earning at the practice location. As a woman and a relatively new attending, I was making disproportionately less than some of my colleagues, and I’m happy to say that situation was remedied immediately.

Autonomy was another one that surprised me. Early on, we restructured our shift and call schedules so they made more sense for our team. It was amazing to decide for ourselves, instead of petitioning the hospital and waiting weeks for an answer. I’ve come to believe that physicians manage themselves much better than hospitals manage physicians.

A common misconception about ownership is that we work harder. Sometimes this is definitely the case, but the beauty of physician-led partnership is that we control our finances. So unlike employees, we can choose to pay ourselves more for that extra work.

SP: In my mind, culture is the number one factor that determines whether you’ll be happy in an organization. When an organization’s mission and values align with yours, you’re set up for a long, happy career. In my experience, many physician groups lack a strong culture and clearly defined values.

At Vituity, not only are our values of democracy, transparency, autonomy, and servant leadership stated upfront, they’re woven into our everyday practice. For example, my medical directors go to great lengths to support their teams through servant leadership. As a leader, I personally believe it’s important to never ask anyone to do anything that I wouldn’t do myself. Every one of the medical directors in my region work more than their fair share of nights, weekends, and holidays. They hold as many committee appointments as their partners and work nearly a full-time clinical load. Each of them understands that they have to be amongst the highest-performing partners in their emergency departments to set the standard of excellence that we expect as a partnership. And they are committed to helping their partners be the best they can be. As the saying goes, “Leaders are those who know the way, go the way, and show the way.”

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Q: Can you share a story that illustrates the value of physician partnership?

SP: As a reservist and first-year partner, I figured it would take me a few years to move into a leadership position. But my first medical director really valued my work ethic and experience and championed my advancement. As a result, I was promoted to medical director after just three months with the Partnership. Vituity offers many opportunities for accelerated leadership development

You don’t see true meritocracy very often in healthcare. But as owners with skin in the game, we always want the best person for the job regardless of educational pedigree or seniority. I believe this allows us to attract a higher caliber of clinicians. High performers want to be with an organization that celebrates high performance.

PM: A few years ago, a regional health system bought my first hospital. At the time, 75 Vituity Partners were working in emergency medicine, hospital medicine, and critical care. The hospital wanted to cancel its physician group contracts and make us employees again. We stood together—each of us making the individual choice to stand with our Partners—and told them we would all walk if it came to that. They wouldn’t budge.

I was a hospitalist medical director at the time and walking into the CEO’s office to give our resignation was one of the most nerve-wracking yet powerful moments of my life. Happily, all three service lines were able to negotiate a better contract with a local competitor. In the end, 73 of our 75 Partners moved to the new health system, which has been an incredible client and collaborator for us. For me, it was a huge testament to the power of ownership.

Q: In your experience, what are the biggest benefits of joining a large multispecialty physician partnership like Vituity?

PM: Vituity really is the best of both worlds: local autonomy with the backing of a national organization and infrastructure. Right now, a lot of independent hospitalist groups struggle with costs, payer negotiations, and administrative burdens. Vituity takes all of that off our plate. They support us with billing, education, IT, recruiting, and everything else behind the scenes so we can focus on our real passion: medicine.

SP: One advantage of working for a large and diverse organization is the opportunity to develop and share great ideas that enhance acute care delivery. Vituity explicitly recognizes that front-line physicians are its greatest innovation assets. Many of our signature practices, like Rapid Medical Evaluation^® and Emergency Psychiatric Intervention (EPI)a, were developed by a single physician or team and shared across the Partnership. Whether in clinical care, business practices, or management, we tap into human capital in a very effective way.

Working for Vituity allows me to be part of an innovative organization that understands that healthcare is fundamentally about people. It’s all about engaging the best talent available to help our patients live healthier and happier lives. And as an owner, the benefits of that come back to me personally and not to a separate group of investors.

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