More Physicians Leaving Independent Practices
By N. Flanagan; http://www.healthcaredive.com; 8/11/15


Accenture’s latest survey, "Clinical care: The independent doctor will NOT see you," reports that one in three physicians will remain independent towards the end of next season, down 10 % from your company’s 2012 report.

An estimated 71,000 physicians left their private practice for hospital employment between 2005 and 2013, with the additional 27,000 projected to leave towards the end of 2016, in line with Kaveh Safavi, global managing director of Accenture’s health business.

“The complexity of running a private practice keeps growing yet not the economics. What’s changed recently is independent practices need more technology, a competent revenue cycle and structure to build enough profit to counterbalance overhead costs,” Safavi said. He added the attraction of solo practice 20 years ago was approximately autonomy, both clinical and business.

“Although self-employed doctors can certainly still tweak their business design as they think acceptable, the clinical side of autonomy has become challenged by way of a certain volume of standardization, so that it remains you can forget prominent in solo practices in comparison to large health systems," he stated.

Similar data was reported within a 2014 survey by The Physicians Foundation. In that survey, only 17 percent of 20,000 physicians said that they a solo practice, down from 25 percent in 2012. Fifty-three percent were hospital or medical group employees, up from 44 percent in 2012.

However, Kurt Mosley, vice chairman of strategic alliances for Merritt Hawkins, which conducted the survey, said physicians can also be seeking employment as a whole clinics, retail medical locations (urgent care centers, stand-alone emergency care, ambulatory surgical centers, etc) and insurance companies can also be hiring physicians. “It’s a fresh world where people who never hired doctors before at the moment are seeking them,” said Mosley.

In addition, together with the trend of huge hospital systems merging, Mosley explained the secret's getting doctors aligned. “It had been whoever had by far the most doctors wins, but this time it’s about getting the right quantity of doctors participating in the correct behaviors in the best settings. Many in the older doctors aren't employed to employed in a team environment and being paid according to patient satisfaction," he was quoted saying.

And the younger physicians, as outlined by Mosley, are trained and ready to figure in a very team environment, but want not even attempt to do while using business of medication. “That correlates with attempting to be applied.”

Reasons to Leave

The top three good reasons cited for leaving private practice inside above surveys, and a third survey conducted a few months ago by Jackson Healthcare, are high overhead and expenses of maintaining a medical practice, reimbursement cuts, and excessive consentrate on administrative tasks rather than patient care.

Physician overhead includes the expense of specialized labor. “Professional labor, which makes up as much as two-thirds of total costs, could be the single most expensive element of healthcare,” said Safavi.

A 2013 article in Western Pennsylvania Healthcare News estimates that overhead is between 60 and 70 percent of practice charges because of increased costs for employee healthcare, reduced reimbursements, expensive technology as well as a more difficult billing process to third-party payers. “With these changes, some physicians have got a half cut in pay – or even more,” this article states.

Medicare and Medicaid reimbursement rates dropped in 2010, averaging a 21.2 percent decrease in Medicare reimbursements, based on DHHS and an average 42.8 percent decline in Medicaid reimbursements for primary care physicians, based on an Urban Institute survey, in accordance with a Forbes article. And a Physicians Foundation’s “2014 survey of American Physicians” mentioned earlier on this page, discovered that 38 percent of doctors don’t see Medicaid patients or limit those they certainly see.

Not only do physicians say they've got an excessive amount of non-medical paperwork, but listed malpractice liability pressures, inadequate and inconsistent reimbursement, lots of government regulations and reduced clinical autonomy as all factors leading to discontentment.

In a 2012 Physicians Foundation survey, 68 percent of physicians described their morale as negative, but that number dropped to 44 percent within the group’s 2014 survey. Mosley attributes this to younger physicians participating from the survey. “In our survey, 66 percent of physicians under age 45 were employed in comparison to only 26 percent aged 46 and older. It seems the doctors that are younger and employed are happier,” Mosley concluded.

As the trends of hospital mergers and acquisitions continue, as well as new consumer healthcare technologies and retail medical facilities, physicians will have to accommodate the changing times, so when Mosley commented, “It’s the latest world.”

 

 

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