Can physician group practices be run well as part of hospital or healthcare system structures?

Yes, but. The “but” is a big one and not easily accomplished. Hospital executives have to cede operational control to medical group practice professionals and collaborate with their employed physicians as partners in the company to make it work. Typically, when private primary physician practices are purchased, hospitals (1) upgrade their space, furniture, equipment; (2) bring their employees onto the hospital wage, salary and benefit scale: (3) require the lab, cardiology, radiology ancillaries to come to the hospital. Go figure: added costs, and up to 30% less revenue. That’s managing like a hospital, not a group practice. The focus on mission-based budgeting and competitive, incentive-based compensation is to co-op the doc practices to do what they do best (see outpatients) and to work with the hospital management team to provide a supportive structure for them to do just that. That’s a leap of faith that can work for both parties.