The  Multifaceted Transformation of Medicine –Quotes and Notes

Quote Number One

The independent, private practice model will largely, though not uniformly replaced. Most physicians will be compelled to consolidate with other practitioners, become hospital employees, or align with large hospitals or health systems for capital, administrative, and technical resources. Physician practice styles will be increasingly less homogenous.  The full-time, independent practitioner accepting third party payment will largely be replaced by employed, part-time, locum tenens, and concierge practitioners.

“Health Reform and the Decline of Physician Private Practices, A White Paper Examining the Effects of the Patient Protection and Affordable  Care Act in the United States,"  The Physicians Foundation and Merritt Hawkins, October, 2010

Quote Number Two

“Both newly minted and veteran physicians face economic uncertainty amid sharpening demands from the government and insurers to improve quality while curbing costs – trends that accelerated under the 2010 health care overhaul.

The buzz, and anxiety, in the medical profession is palpable – trade magazines tout new coping strategies, doctor groups discuss the transformation of practices. Physicians are experimenting with business models and new practice techniques, hoping to find work that is both financially and personally rewarding.

"It's not just the financial piece," said Dr. Susan Turnkey, executive director of the Medical Group Management Association, a practice management consultant firm.

"It's also the clinical -- it's bridging a gap so you can make the best decisions all around."

The changing landscape is reflected in the growing number of doctors who are employed by others, rather than working for themselves. Consulting firm Accenture reported in 2012 that the proportion of independently practicing physicians, working in groups or solo, will fall to 36 percent this year. One-third of those will choose a subscription-based model.

The majority, though, are seeking steadier salaries and hours: about 91,300 doctors and dentists were employed by community hospitals in 2010, according to the American Hospital Association, 30,000 more than in 1998.

Ankita Rao, “Doctors Transform How They Practice Medicine,” Kaiser Health News, May 15, 2012

Notes

It is now apparent doctors are changing how they practice in response to reform pressures, both from the government and private sectors.  Establishing and maintaining a private practice is fraught with risk.  The safest thing to do is to go to work for a hospital.  A second  strategy is to become a locum tenens physician,  A third is to enter a cash-only practice. A fourth, if you have an existing large patient base, is to transform your practice into a concierge model, charging a monthly or annual subscription fee for guaranteed  24/7 access  and other services.  A fifth  is to join an Accountable Care Organization or form a Medical Home, s choices favored by federal government,  A sixth  approach is to  negotiate some sort of hybrid partnership with hospitals, where you are reimbursed by the hospital for referrals and a tighter relationship.

Tweet: In response to economic and regulatory pressures, private practices are mutating into other practice models.