By Nathan Morgan

Health care consolidation doesn't just mean giant national hospital chains buying each other. It also means physicians and their practices turning to hospital owners who can take care of the increased logistical, administrative demands of health care today.

Coping with that shift is one of the biggest priorities for Dr. Michel McDonald, director of dermatologic surgery at Vanderbilt and new chairman of a state medical association. (McDonald is the group's first female chair, a fact she finds unusual given the stronger female presence on the clinical side of medicine when compared to the business side.)

McDonald, who's always been an "employed physician," said the transition away from the private practice model to an employment-based one has created new challenges for physicians.

"It means that as a physician you might not be as involved in contracting with insurance companies, because your employer takes care of that," McDonald said. "Even sometimes hiring and firing of employees or a lot of the logistical business issues that [would be different] if you were the actual business owner."

For the us, then, the goal is to make sure those physicians are still involved in those and other processes and can access the support they want from the association.