Cardiology Employment: Keys to Post-Transaction Success

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Got cardiologists? In the wake of completing a transaction, it is important to not lose sight of the value that employed cardiologists can bring to the organization. Employed cardiologists should be viewed as strategic assets. For the relationship to be effective in the long term, hospitals must be able to incorporate a physician focus into their overall strategy and leverage the new relationship. When engaged correctly in an aligned relationship with the CV service line, employed cardiologists can be a driving force behind executing the service line’s most critical strategies. Unfortunately, employment does not automatically create alignment. To achieve true partnership, specific tactics, such as involving cardiologists in strategic planning, designing physician-driven management and governance structures, and engaging physicians in operations improvement efforts, must be targeted.

Involvement in Strategic Planning

The single most important factor to focus on post-employment is actively involving the cardiologists in strategic planning. Doing so can shift the physicians’ focus from the anxieties and frustrations felt in practice transition (i.e., fear of diminished control and operational inefficiencies) to a broader perspective on program development and the cardiologists’ role in the hospital’s CV program. Engaging recently employed cardiologists is valuable in that it provides them with the ability to help shape the future direction of the hospital and engages them in programmatic development. Inclusion in the strategic planning process allows the plan to have the benefit of physicians’ clinical expertise and leverages their knowledge of the market. Physicians will be more likely to advocate for the strategic plan and drive implementation if they are responsible for the plan’s development.

Designing Physician-Driven Management and Governance Structures

The purpose of creating dedicated roles for physicians within the CV service line is that it gives them a voice and demonstrates the hospital’s commitment to physician leadership. Creating a dyad or triad management structure for the service line, in which a physician leader partners with an administrative and/or nursing leader, solidifies the physicians’ role within the management team. Appropriately leveraged, this physician service line leader can aid in bringing a clinical perspective to the decision-making process. This can be an extremely effective model for creating physician alignment, but it requires the presence of a physician with business acumen who is willing to only practice clinically on a part-time basis. Top-performing CV programs also create governance structures that include physician representatives from multiple specialties and from both employed and private practice groups. Having all key stakeholders included in a service line leadership committee ensures that all constituencies are represented and creates a venue in which the decision-making process can be accelerated. This governance construct demonstrates to physicians their role in the service line as well as the hospital’s commitment to their active involvement. In situations where there are employed and private practice cardiologists, it can also provide an opportunity for both constituencies to work collaboratively and have an equal voice in the service line. Typically, functions of the leadership group include developing and implementing strategic plans, providing input on budgets, and monitoring the performance of the service line, among other responsibilities.

Engaging Physicians in Operations Improvement

Finally, the move to employment can be used as the catalyst for engaging in needed operational improvement efforts. It is not uncommon for groups to put off engaging in such initiatives for fear of disrupting group dynamics or because the managerial expertise was not present. Moving to employment is a time of transition, so it can be used as an opportunity to investigate practice performance and focus on key areas for improvement. Examples include ensuring optimal billing performance, defining physician performance expectations, and investigating means to enhance patient access to care. Leveraging the hospital’s practice management capabilities, the group can work in partnership with the hospital to enhance operations within the practice, which is a boon to both parties. Efforts can also be targeted at enhancing hospital operations and developing a dashboard of key performance metrics.

The benefits to both physicians and the hospital of pursuing these initiatives post-employment are detailed below.


When executed appropriately, cardiology employment can have a demonstrable impact on the hospital’s cardiac program. Specifically, it can yield market share gains, improve patient access to care, and enhance coordination of care, among other benefits. These goals are only achieved through targeted efforts to align with the physicians, however. Alignment with the newly employed cardiologists can be achieved by quickly demonstrating through actions that they are not only partners in the hospital’s CV program, but that they are linchpins for its success. Through focusing on efforts such as strategic planning, service line development, and operational improvement, physicians can be engaged in a meaningful way that has a positive impact on both their clinical practice as well as the CV service line. While the transaction process can be daunting, the post-employment world provides the opportunity to create a positive environment and realize the value of employment.