In India’s highly physician-centric healthcare model, independent physicians running their own clinic and consulting at 2-4 hospitals alongside are pretty much the norm. Patients, too, are used to seeking out doctors as per their availability.

Over the past few decades, increasing corporate investment in healthcare has brought with it greater competition, a sharper focus on returns and enhanced awareness of global practices, which favour the full-time physician model. Now, the salaried physician as a trend is steadily picking up in India’s private healthcare sector as well. The model comes with its pros and cons. Below are the pros:

If the experience of the biggest hospital systems in the world is anything to go by, the pros of full-time employment far outweigh the cons. In the USA, in fact, employee physicians now outnumber independent practitioners. Consistently best-rated hospitals such as the Mayo Clinic, Johns Hopkins Hospitals and the Cleveland Clinic all operate on this model. In Europe, marked by publicly funded healthcare systems such as the National Health Services (NHS) in the UK, salaried physicians are the norm. In France, medical graduates increasingly prefer full-time employment over becoming GPs, a trend that can also be observed in Germany where independent family physicianship is losing appeal among young doctors. A similar trend prevails in Canada as well.

A successful Indian example

Mumbai-based Kokilaben Dhirubhai Ambani Hospital (KDAH) adopted the full-time physician model right from its inception after studying the operations of the best hospital systems of the world. It’s Executive Director, Dr Ram Narain, explained at the Abbott Hospital Leadership Summit, 2017, that the hospital really had to invest its resources in establishing the model in the city and making full-time employment enriching for its doctors. Here are lessons from KDAH’s experience:

  • Provide attractive remuneration: Most physicians are hesitant to take up full-time employment because of the perception that the more hospitals you consult at, the more patients you get. As such, physicians invest years in building a patient base through their own private and consulting practice. Kokilaben Hospital largely sought out medical practitioners used to the employment model due to a stint abroad in systems such as the NHS, and paid them well to incentivise their return to the country. This also helped in easing any concerns about losing out on patients and, thus, income. Dr. Narain explained, “You have to absorb this cost, incubate this talent for two, three, four years. Only then will you see, to use business terms, return on investment.”
  • Project your doctors: Notably, the KDAH took the onus to position and project its hirees, as opposed to the consulting system in which hospitals often depend on established consultants to draw in patients. According to Dr. Narain, hospitals need to be patient through the initial gestation period of 3-4 years as referring doctors, patients and patients’ families begin to develop trust in the absence of big names.
  • Proactively work towards attracting new talent: Kokilaben Hospital also conducted a comparative study to convince newer talent of the merits of full-time employment, and to dispel the myth that the model attracts fewer patients. It found that many of its surgeons are, in fact, much busier than ones juggling several hospitals and clinics.
  • Value your employees: Dr Narain pointed out that the challenge, now, is to retain their doctors who are well established and have earned a reputation in their speciality. But, he said, if you take care of them, they prefer to stay. This includes valuing their non-clinical skills as well and utilising their input in operations - in other words, practising participative management. At KDAH, every clinical director is a part of a strategic business unit and is fiscally responsible.  

Dr Narain feels that the sense of pride and belonging promoted by full-time employment among its employees helped the hospital execute strong clinical governance, and prioritise patient centricity alongside clinical excellence.The example of Kokilaben Dhirubhai Ambani Hospital shows that with patience and proper management, the full-time physician model can prove to be fruitful for hospitals as well as for physicians.

This article is meant for informational purposes ONLY and does not constitute or imply an endorsement, sponsorship or recommendation of any products or a person’s point of view. Although greatest possible care has been taken in compiling, checking and developing the content to ensure that it is accurate and complete, Abbott Healthcare Private Limited, are not responsible or in any way liable for any errors, omissions or inaccuracies and/or incompleteness of the information.