This summer, the American College of Physicians (ACP), which represents 130,000 internists, will publish a series  of papers that will tell America’s doctors what they should and should not order in diagnostic tests and therapies, a guideline that strives to lower cost while eliminating unnecessary care.

The number of physician-owned medical practices is declining. In 2005, two-thirds of all medical practices were doctor-owned, but the number is now below 50%, according to the Medical Group Management Association. More physicians are looking to sell their practice in favor of being employed by a larger medical group or hospital. Some are tired of managing the business, whereas others are concerned about the impact of healthcare reform on their practice. 

In the past, many physicians considered their medical staff leadership responsibilities a privilege and thus did not demand compensation. However, in recent years, it has become common practice for hospitals and medical staffs to compensate chiefs of staff and medical staff presidents, committee chairs, and department chairs for their leadership involvement.

Before joint replacement patients set foot in an operating room at the Agnesian Center for Bone and Joint Health, they start in a multidisciplinary presurgical education session. A nurse answers questions about the surgical process, a pharmacist talks about anticoagulation and pain medication, a rehab representative explores home modifications and other postsurgery issues, and a discharge planner lays the groundwork for the postsurgery transition. By surgery time, not only does the patient have a better idea of what to expect from the process, but so do the providers.