As we begin the journey to value-based healthcare, the relationships between a hospital and its medical staff are changing. For decades, these relationships were straightforward: Doctors admitted patients to the hospital, performed procedures and delivered therapies, and at some point, sent the patients home. This simple formula was the business model for hospitals, and it worked well.

Same for the doctors. The hospital would pretty much let them do what they wanted as long as they took calls, made the patient rounds, and weren’t too disruptive.

Doctors worked under a tacit understanding that they didn’t question each other’s care. This “craft of medicine” worked for the doctors but not so well for the patients.

For better or worse, hospitals are taking the lead in risk-based reimbursement models, dragging the medical staff with them. Risk-averse doctors aren’t sure what to do and may sit on their hands until the payment schemes catch up with them, and that is a bad strategy.

Doctors should work to help hospitals improve. From being a doctor, I’ve learned several reasons why.

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