Grassroots Report - Impact of Health Reform on Private Practice Physicians

Among national physician advocacy organizations, none have been more effective than the Physicians Foundation, a non-partisan, charitable non-profit, grant-making organization, in telling the story of how health reform will affect grassroots physicians in private practice and their patients. This is an important story. These physicians provide 70% to 80% of care in the United States.

Surveys and White Papers

The Physicians Foundation has commissioned a series of surveys and white papers that present compelling evidence that:

• One, primary care physicians are suffering from low morale and overwork.

• Two, high costs and regional differences are directly correlated with poverty.

• Three, a huge influx of new Medicare and Medicaid patients may create a physician access crisis.

• Four, health reform may signal the end of private practice.

Latest Report’s Chilling Prediction

In conjunction with Merritt Hawkins, the nation’s largest search and consulting firm, the Physicians Foundation has issued a chilling press release. It bears the ominous title “Report: Health Reform Spells the End of Private Practice Physicians: 74% of Physicians Will Retire, Work Part-Time, and Or Seek Other Alternatives.”

The Report, entitled “Health Reform and the Decline of Private Practice,” examines potential impacts of the Patient Protection and Affordable Care Act on medical practice in the United States.

Lou Goodman, PhD, president of the Physicians’ Foundation, concludes, "The private practice physician is rapidly disappearing. Both market forces and the health reform law are forcing physicians to find new ways of running a practice. We are extremely concerned about how this will affect patient care.”

Four Likely Physician Career Paths

The report says physicians are likely to follow one of four new career paths.

They will either work as employees of increasing larger medical groups or hospital systems, establish cash-only practices without third part payers, reduce their clinical roles by working part-time, or leave medicine by accepting non-clinical positions or retiring.


The report includes case studies of new practice models --- medical homes, accountable care organizations, concierge practices, community health centers, and small, hospital aligned practices.

A National Survey

Finally the report announces results of a national survey to which 2,400 physicians responded. Only 26% of those surveyed said they would continue to practice as they have in the past over the next one to three years. The remaining 74% surveyed said they would retire, work part-time, close their practices to new patients, become employed, or seek non-clinical jobs.

The white paper predicts health reform will accelerate the existing physician shortage and make it more difficult for patients to find a physician. The purpose of the report is not to undermine health reform but to point out how its provisions will affect conditions at the grassroots of the delivery system.

Protecting the Patient-Physician Relationship

Walker Ray, MD, Research Committee Chair for the Physicians Foundation, commented, “For the sake of all Americans, it is critical that we find ways to protect the patient-physician relationship and make sure that no outside forces are interfering with clinical decision making.”

For more information: contact Phil Miller, 469-524-1420/phil.miller@amnhealthcare.com, and visit the Physicians Foundation website, PhysiciansFoundation.org.

Richard L. Reece, MD, of Old Saybrook, Connecticut, blogs at Medinnovation and is author of two recent books, Obama, Doctors, and Health Reform and Innovation-Driven Health Care, He works closely with The Physicians Foundation, a 501-C3 organization representing 700,000 physicians in state medical societies that issues grants to physician organizations to improve care. He can be reached at rreece1500@aol.com or 860-395-1501