Physician-hospital alignment: "employment lite".

The American healthcare delivery system is undergoing a major change that involves independent solo and small groups of doctors becoming employed by hospitals. Some describe this as a paradigm shift; we view it as a tsunami that is engulfing physicians across the nation. This phenomenon is unfamiliar to most physicians and represents huge risks with the shift from private, fee-for-service practices to practicing as an employee of a hospital. This article discusses the pitfalls associated with the transfer to a hospital employee using a concept called "employment lite." It presents the advantages and disadvantages of employment lite and why this might serve as an alternative to a fully employed hospital physician. The employment lite option is similar to employment in that it allows the physician to enjoy most of the nuances of employment, yet maintain a desirable level of independence.