Much has been written on the death of private practice.
A lion’s share of the reason is economic. It’s becoming financially unfeasible to run a private practice and practice medicine at the same time. The increasing bureaucracy and regulations will only get worse.
And many doctors are responding by becoming employed by hospitals or by large, integrated health practices, and giving up some independence.
Some will continue to resist this trend. But others, especially the next generation of physicians, will not.
A recent New York Times piece details the prevailing attitude of incoming doctors. The piece, focused on new emergency physician Kate Dewar, is how new doctors generally prefer a more balanced work-life schedule.
When telling her father that she accepted a salaried position,
her father also remembered being both envious and disappointed. “On the one hand, it bothers me that the generation of doctors that my daughter is in doesn’t work as many hours and isn’t willing to do the stuff that I did,” he said. “On the other hand, I’m almost a little jealous.”
Such mixed feelings are common among older doctors, many of whom have been unable to sell or even give away their practices because younger doctors are not willing to work the hours required. Indeed, Dr. William Dewar III’s practice has hired nurse practitioners recently, in part because it cannot recruit doctors.
Large conglomerates of employed physicians will soon become the dominant model of care in the United States. This change is not only coming from the top down, but from the bottom up as well.