Three years ago, independent physicians ruled the roost at Medical Center Health System, a 403-bed community hospital in Odessa, Texas. At that point, the health system employed only half a dozen physicians, mostly primary care docs who doubled as hospitalists. Today, the employed medical staff numbers 30, encompassing both radiology and anesthesiology. And the number is going to keep growing, says Gary Barnes, CIO. "When we're recruiting medical staff, we try to bring in private physicians first, but more and more, they want to be hospital-employed," he says.

The reason? For Barnes, the answer boils down to one simple fact: Running a private group practice, of whatever size, is increasingly a difficult undertaking, one that fewer and fewer physicians are keen on doing. "If you come in as an employed physician, we can take care of the billing and the medical records, and you can practice medicine instead of trying to manage a business and make a profit."

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