Are cardiologists more powerful when employed by a hospital?

I once told a physician friend that he and all doctors would eventually have to give up private practices and be employed by a hospital. “No,” he told me. “I will die with my boots on.”

But do the dreaded hospital acquisitions of private practices actually empower doctors — and in particular, cardiologists?

The Philadelphia Inquirer reviewed the acquisition of private cardiology practices and came up with the usual subjects: a squeeze by payers and the increased costs of running a practice, among others. But the article also pointed out that cardiologists drive new healthcare innovation in hospital systems. Here’s what happened when a pair of cardiologists at Lourdes Health System became comanagers of the hospital’s cardiac services:

• They standardized treatments and started using a cheaper blood thinner.
• They encouraged the hospital to equip ambulances and the emergency department with equipment that diagnoses a heart attack before a patient leaves home. The change cut the time to perform a catheterization by 15 minutes.
• They created units that include nurses with expertise in heart-failure and heart-surgery patients. The measure cut hospital stays and improved patient satisfaction.
• The hospital hired two family physicians for home visits with heart patients.

The theory on why all the changes? “These doctors are totally engaged in this process. And why? Because they suddenly feel like what they say matters,” Reg Blaber, a vice president at Lourdes, told the Inquirer.