Liberty Medical Foundation, which includes Liberty Medical Group (LMG) and Liberty Medical Plan (LMP), is a physician-centered, group-practiced health maintenance organization. Liberty was one of the first organizations to embrace “evidence-based” medicine, whereby an effort was made to identify best practices and develop standardized protocols for applying them, limiting the need for unnecessary tests and procedures. Liberty also invested in education and information about “home treatment” to aid minor illnesses and injuries to begin treatment without the need of a physician. However, although Liberty had managed to successfully survive with this structure, the medical setting and patient satisfaction had begun to negatively impact LMF both internally and externally.
Among the internal factors LMF currently faced was the recruiting of new physicians. Before Dr. Townsend was appointed as the new CEO of the organization, a few changes in policy caused a decline in the comfortability of the LMG physicians. These changes shifted the way in which health care was delivered to a team based system that heavily relied on NP’s, PT’s, health educators and support staff which meant less Physician-Patient interaction. This new policy also brought about a change in the way physicians were being compensated. With the new policy in place, physicians were given two options; they were required to either increase their workweek by half a day with no pay increase or they could have accepted a decrease in their current salary. These policy changes obviously created a negative impact on the physicians of the organization, which demonstrated that the executive staff was “isolated” from the realities of the daily medical practices. Another internal issue affecting the organization was