Doctors leaving private practice, and where to go next

It’s becoming apparent that the solo and private practice model of primary care is dying a slow death.

PookieMD interviewed me, as well as retainer physician Kevin Lutz, about the divergent paths that one can take after leaving private practice.

I represent the hospital-owned practice route, and here’s my take:

He opines that, “primary care is the loss leader for the hospital,” explaining that primary care brings business to the hospital, and that this is the main benefit to the hospital. Dr. Pho notes that he may have sacrificed autonomy for job security, but feels that primary care is destined to end up with the model he works in.

It’s becoming increasingly difficult for an independent, small-group practice to financially stay afloat. Already, we’re seeing both hospitals and large integrated health systems buy these practices, with more doctors willing to sacrifice their autonomy for more stable financial footing.

In turn, these larger systems are more willing to tolerate a negative balance sheet, in exchange for the specialist referrals and diagnostic test utilization that primary care providers provide.

In other words, if the health care system were an electronics store, primary care would be the equivalent of cheap DVDs – loss leaders bringing patients in to potentially generate more lucrative business.

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  • Anonymous

    Its very tempting to leave medicine altogether. I’ve already talked to my local university. Next medicare cuts and I’m going to the university to teach Biology and Anatomy.

  • Anonymous

    Our small family practice of 3 physicians was going out odf business. We were stuck in contracts that were reimbursing 80% medicare, agreed to at a time when we felt some patients were better than no patients. Finally, we were able to join a larger group of almost 100 physicians, and overnight these same contracts went to 130-140% medicare. The irony is the indurance companies are now paying more; if they had offered us 110 % medicare, we probably wouold have been stupid enough to accept it.

    A family practitioner

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