Hospitals are buying up medical practices. Richard Gunderson, writing in The Atlantic, reports that the number of physicians employed by hospitals grew by 34% between 2000 and 2010. In 2004 hospital human resources departments conducted only 11% of physician searches. Today that figure is 63%.
Number of Hospital Employed Physicians up 34%

Hospital administrators argue that by employing their own physicians, their institutions can achieve greater integration of care. They can avoid variations in practice, such as the use of different medical devices for the same procedure—a common practice in joint replacements. They maintain that, when doctors are employees, hospital administrators can bring about better coordination of care among different medical specialties. Gunderson points out those hospitals can also charge more for certain tests and procedures.
A major hazard of physician employment by hospitals is that doctors may feel that they have lost control over their practice, according to Gunderson. Morale may suffer if doctors are subjected to excessive institutional rules and regulations and feel pressure to practice according to prescribed patterns.
A recent study showed that the most important factor in promoting professional fulfillment among physicians is their ability to provide high-quality care to patients. Whether doctors work for a hospital or for their own practice group, the best tonic is ensuring that physicians can continue to care for patients as they see fit.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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