Are the days of the independent physician coming to an end?

I think so.

The NEJM has a perspective piece on the declining percentage of doctors who practice independently. Depending on the source, the number ranges from 29 to 61 percent.

It is becoming increasingly difficult for doctors not to be supported by a hospital or large integrated health system. With reimbursements declining, many doctors are opting for the relative security of a salary.

Furthermore, joining a large group makes it easier for a doctor to adopt electronic medical records, coordinating care for the chronically ill, or adhering to practice guidelines.

These trends will ensure that the consolidation of doctors into larger groups will continue. Whether this definitively benefits patient care is still unclear, but I suspect that patient outcomes will likely improve as this movement continues.

Comments

Anonymous
There is a trend away from independent practice but you overstate the advantages of employment in a medical system.
Low payments from insurers will still translate into low pay for physicians, especially in primary care. The big medical systems can’t subsidize money losing clinics to the extent they could in the past.
Given the poor state of current EMRs, care coordination, and guidelines, those aren’t driving the trend to employment as much as fear of owning a business during the slow painful collapse of third party payment medicine.
Physician Disability Insurance
Great posting. This is so true, I’ve seen many independent practitioners move back to the hospitals and umbrella practices. They just don’t have the support they need unless they pay for it themselves. Luckily there are some way for physicians to do this.
Anonymous
Not everybody is made to be an employee. I work part time as an independent physician and part time being employed by a large MSG. I hate every minute of the way the group treats the patients. It is the difference between a plastic spoon “made in China” but nicely packed and a hand crafted silver spoon sold in a plastic bag.
The problem is, most patients have forgotten how it feels when the doctor knows your name and your voice on the phone.
Bad Medicine, Good Solutions
No, their days are not over. Physicians just aren’t looking at their options.
Look here: http://www.simpd.org/
http://impmo.org/
These two organizations are offering variants of comprehensive medical practice models. One functions within the current system of insurance, the other outside in the realm of cash.
Both are quite viable. This is how comprehensive care is to survive. Not through government quality mandates, HMOs, or PPOs. The solo physician is the original medical home and will continue to offer the best medicine for patients.

Are the days of the independent physician coming to an end?

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