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-Studies should avoid over-adjustment for light intensity activity when studying the relationship between sedentary behaviour and health, as light intensity activity is by definition almost the inverse of sedentary behaviour.

-Studies testing the independent association between sedentary behaviour and health are advised to adjust for total volume of physical activity (in mg or counts, not minutes), not just time spent in MVPA. Otherwise the resulting association may simply be reflecting the beneficial effects of doing more light intensity activity, not the detrimental effect of more time spent sedentary.

MH would like to thank wordsmiths Dr. Brad Metcalf and Dr. Richard Pulsford for their editing skills in the section written by MH.

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Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
Sydney School of Public Health, University of Sydney, Camperdown, Australia
College of Life and Environmental Sciences, University of Exeter, Exeter, UK
©The Author(s).2017

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International Journal of Behavioral Nutrition and Physical Activity

ISSN: 1479-5868

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1 mass noun The state of something with regard to its appearance, quality, or working order.

in singular
state , shape, order
in singular
fitness , physical fitness, health, state of health, form, shape, trim, fettle
disorder , problem, defect, disease, illness, complaint, ailment, weakness, infirmity, malady, indisposition, malaise, sickness, affliction, infection, upset
standing , rank, ranking, position, social position, station, level, footing, place

2 conditions The circumstances or factors affecting the way in which people live or work, especially with regard to their well-being.

conditions
circumstances , surroundings
circumstances , context, conditions, situation, environment, milieu, scene, scenario, framework, atmosphere

3 A situation that must exist before something else is possible or permitted.

stipulation , constraint, prerequisite, precondition, requirement, rule, term, specification, provision, proviso, qualification

1 Have a significant influence on or determine (the manner or outcome of something)

constrain , control, govern, determine, decide
with object and infinitive
train , teach, educate, coach, tutor, guide, groom, drill, accustom, adapt, habituate, mould, inure

2 Bring (something) into the desired state for use.

treat , prepare, make ready, ready, prime, temper, process, acclimatize, acclimate, adapt, adjust, soften, season
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Executive Summary

How can hospitals and health systems generate a return on their investment in their physician enterprises? According to themost recent figures, from the American Medical Association, over 25% of U.S. physicians practiced in groups wholly or partly owned by hospitals in 2016 and another 7% were direct hospital employees. Yet, according to the Medical Group Management Association, hospitals’ multi-specialty physician groups lost almost $196,000 per employed physician. As a result, some larger health systems’ physician operations are generating nine-figure operating losses, which are major contributors to thedeterioration in hospital earnings. It is time for hospitals or health systems to rethink their strategy for their physician enterprises.

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How can hospitals and health systems generate a return on their investment in their physician enterprises? According to the most recent figures , from the American Medical Association, over 25% of U.S. physicians practiced in groups wholly or partly owned by hospitals in 2016 and another 7% were direct hospital employees. Yet, according to the Medical Group Management Association, hospitals’ multi-specialty physician groups lost almost $196,000 per employed physician.

As a result, some larger health systems’ physician operations are generating nine-figure operating losses, which are major contributors to the deterioration in hospital earnings . It is time for hospitals or health systems to rethink their strategy for their physician enterprises.

Let’s first revisit why independent physicians were receptive to becoming employees and why hospitals and health systems felt the need to hire them.

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