Core Competencies for Physician Practice Success (Transition to Capitation‪)‬

THE PRACTICE OF MEDICINE IN THE 1990S IS BEST characterized by the word "change." Change takes many forms--those occurring in medicine are not incremental, but represent a paradigm shift that has affected all providers, most notably physicians. Multiple factors contribute to this new paradigm, including: an emphasis on cost management, the emergence of "customer" service as an important parameter, attention to measures of quality as defined by external agencies, debate as to what constitutes quality and value, and market-driven reforms. The industry's evolution is stressful for most physicians, as the profession's traditional values of autonomy and self-esteem are being challenged. The growth of managed care--with the resulting consolidation, cost control, and profit-oriented players entering the market--is a major source of concern. Largely due to this market evolution, physicians find themselves in the position of working within a single management paradigm and attempting to apply it in two different contexts: capitated payment systems and traditional fee-for-service medicine.