A big misconception about a hospital-employed physician services model is that for it to be successful, your health system must manage its emergency medicine and hospital medicine physician practices alone – or, if that’s not working, hand it off to an outside physician management group.

There are many services and solutions available to support and strengthen our hospital-based physician practice management that don’t require giving up control, and many of which make your job as a hospital administrator undeniably easier.

Here are four of the most common challenges faced when employing emergency medicine and hospital medicine physicians, and tips to help you find the best solution for your health system.

Challenge No. 1: Recruitment & Retention

Turnover is inevitable. When it happens in the hospital setting, the pressure to quickly find outstanding candidates can exceed the manpower of your recruiting team. What options do you have for this common challenge?

1. You could expand your recruiting team.

Pros: More recruiters searching for prospects across the field could bring better results down the line.

Cons: Though this is the most desirable option, the time and cost of hiring additional recruiters make it the most expensive as well.

2. You could restructure. 

Pros: If your existing recruiting team can divide the medical specialties among them, and narrow their focus on one specialty each, they could gain deeper knowledge about the clinical team’s culture, priorities, and needs. Strategically, this can be extremely beneficial, as they’ll develop a true understanding of the language of that particular specialty and a bigger (and hopefully better) network of candidates.

The bad thing? It takes time to optimize the right structure for specialty-specific recruiting, which can further stress an already-stretched clinical team.

Challenge No. 2: Leadership & Accountability

Medical Directors oftentimes feel like an island, since their unique department sits within a much larger hospital ecosystem. How do you keep them engaged and accountable?

1. You could meet one-on-one regularly.

This is an obvious, but time-consuming, option. However, if you want to keep a pulse on the progress within the emergency department and hospital medicine department, meeting monthly with your Medical Directors can help identify any challenges and solutions. This consistent support will help give stability and maintain a more cohesive team, all moving towards the same aligned goals.

2. You could provide training and mentorship.

The right leaders appreciate professional development opportunities. There are leadership training opportunities available that are a quick and impactful way to strengthen your Medical Director’s skills. Try to find courses that cover talents needed in leadership, like financial management, industry knowledge, strategic planning, and operations. And, you can support your Medical Director with ongoing mentorship. Find a board-certified EM physician or Hospitalist with several successful years in management who can give appropriate guidance and feedback.

BONUS: Once you’ve established the right Medical Director, evaluate their skills by considering these important questions.

Challenge No. 3: Performance Management

Tracking and analyzing up-to-the-minute reports is difficult but necessary to make sure your health system is firing on all cylinders. However, this requires considerable work, time, and data. What can you do?

1. You could take on the task yourself.

This is the inexpensive option but clearly the most taxing. We suggest you work closely with your HIM and coding departments. They can help automate systems for reporting key metrics like department performance, physician productivity, and patient satisfaction. With the right data, you can then meet regularly with the Medical Director to evaluate performance and work toward any improvements needed.

2. You could divide and conquer.

Like many great team projects, sometimes you need to divide duties according to skills and interests. Disbursing monitoring and mentoring across your leadership and administration could greatly help. However, you’ll need to frequently collaborate to avoid information silos among C-suite counterparts.

Challenge No. 4: Documentation & Revenue

This sometimes hidden challenge could lead you to believe your Revenue Cycle Management (RCM) is running fine, when in fact you’re leaving money on the table. Request a free audit from a reputable firm specializing in emergency medicine and hospital medicine, just to make sure. If the audit reveals that you’re missing out on earned revenue, there are a few options to consider:

1. You could improve documentation.

Discrepancies in documentation can be a big contributor to missed revenue. Spend time developing a clinical documentation improvement program to assure providers capture crucial details and word information correctly. Unfortunately, this is costly and time-consuming, and until it launches, you could continue to miss revenue.

2. You could build a personalized support structure.

A dedicated Revenue Cycle Management specialist can give consistent feedback and oversight for clinical documentation improvement initiatives. They can help ensure clean claims, compliant documentation, and reasonable A/R rates, among other things, by working closely with your clinical team and revenue experts.


If it seems like most of the solutions mentioned above are too time intensive, too costly, or both, you’re not alone. However, there’s a unique solution gaining popularity in the industry – a Management Services Offering (MSO) model. With the continued transition in today’s healthcare environment to value-based services and challenges with reimbursement, hospital leaders and provider groups are leveraging Management Service Offerings for practice management, administrative support, and nonmedical functions to control costs and maximize efficiencies.

Among the many benefits of an MSO model, cost is the biggest driver of interest. Because this model presents à la carte services (like billing and coding) an MSO can increase overall productivity without unnecessary expenses. This type of management model can help with industry complexities as well by providing the technology, infrastructure, and resources needed to improve efficiencies and produce better practice coordination. Hospitals often find additional benefits in reducing duplication of services across organizations – i.e., one MSO can provide a combination of services that a facility may currently be contracting across multiple vendors. All of this helps drive better patient experiences and strengthen hospital and physician alignment on goals and objectives.

It’s possible to outsource only your health systems’ recruiting, documentation education, analytics, leadership development, operational and/or financial management to an organization that specializes in ED and hospital medicine management for hospital-employed physicians. You maintain control while; the group stays abreast of the ever-changing reimbursement rules; has a robust, vetted, national recruiting network at the ready; can pair tools and service for hands-on metric tracking; guides the clinical team to reach hospital goals, and is fully accountable for the results.

Every option contained in this post is available to you through SCP. Speak with our team and discover how SCP’s range of management services can help you achieve your goals.