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Fighting the Tide Against Independent Physicians

Philip Betbeze, for HealthLeaders Media, November 11, 2011

Independent physician practices are slowly fading away, and with the advent of healthcare reform, the pace may be about to get much quicker. It's only one of a few troubling signs about the physician labor pool, which seems increasingly dissatisfied with their career choice and the direction of the healthcare industry.

Physicians are being pushed to employment in hospitals or by hospitals, and they're not necessarily happy about it. To be sure, some, especially recent medical school graduates, like the safety, the (somewhat) regular hours, and the freedom to practice medicine rather than worrying about small business concerns that an employment contract offers.

On the whole, though, physicians' dissatisfaction is palpable. According to the physician component of the 2011 HealthLeaders Media Industry Survey, 58% of doctors say that healthcare reform has weakened their organization's financial position—even though many of its provisions haven't kicked in yet!

Even worse, 60% say healthcare reform has weakened morale, and only 67% of them would encourage their child to enter healthcare. Not exactly encouraging for an industry that needs more physicians.

Here's further evidence that physicians are rethinking their choice of career: Merritt Hawkins, a national physician search firm, recently released a survey showing that, despite the fact that 75% of physicians coming out of training are getting at least 50 job solicitations, close to 28% of the same group said that if they had the chance to do it all over again, they would choose a different profession.

How depressing is that?

 I could imagine, in theory, being quite happy in a field that provided me 50 job offers upon completion of my studies and training. I hope I'm not letting a big secret out of the bag by saying the demand for journalists is just a little less strong than that. In any case, physicians see that reimbursements are declining.

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1 comments on "Fighting the Tide Against Independent Physicians"


Arun K. Potdar (11/15/2011 at 8:50 PM)
I am glad to see that you have brought this subject in the forefront of all the discussions going on in the US in health care reform platform. I spent my working life in the various aspect of the American Health Care Systems starting with regulatory bodies and ending in the executive management of Medical Campus. Your article is not only on the mark it is an eye opener for the new physicians. I have been studying and following the reform movement in health care and I want to say that; a physician employee is the worst employee you can have. I worked for a staff model HMO and what happened to these noble professionals is appalling to narrate here. Yes there is a way for physicians to remain independent but they need to be entrepreneurial non only in practice but also in the idiosyncrasies' No longer you have the advantage of prevailing and customary charge based reimbursements and that is what RVS based fee schedules are. A new physician entering in the market is by default well verse in modern technology in handling electronic communications and for such an individual operating under IT dominated decision support systems is a that proverbial, "piece of cake" and that is what we are looking at in the twentieth century Medicine. The opportunity for the new physicians to be innovative and proactive are enormous' Feds are funding it. My own alternative to Hospital based or worst; Managed Care owned Physicians is to set up an MSO; albeit a bad concept of eighties but an organization concept that can be adopted to meet the challenges of tomorrows health care with physicians directing it. I developed one model that will give the physicians the freedom they must have and the reward they deserve while reducing this dominance of the Third Party Payers (TPP) organizations on the care of patients. No longer a Hospital CFO will discharge a patient as a New Yorker Magazine's cartoon depicted it in early eighties .