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Physician Independence Not Incompatible With Reform

Philip Betbeze, for HealthLeaders Media, January 27, 2012

Plenty of people will tell you that the independent physician is a rapidly dying breed. A few reasons they cite:

  • Coding, billing, and collections are getting more complex.
  • It costs a lot of money and effort to achieve meaningful use standards.
  • Learning team-based medical practice is difficult.
  • Young physicians don't want the hassle and long hours of running a business in addition to seeing patients.

I could go on and on. It's true that challenges like these aren't going away. Indeed, they're a necessary part of the transformation of healthcare into a more predictable, more high-quality endeavor.

That doesn't mean they don't cause a lot of upheaval. Some of this upheaval means lots of formerly independent physicians are giving up the business side and joining as employees with hospitals, health systems, and health plans. Some physicians equate that outcome as "giving up."

The challenges of adaptation are real and seismic for every healthcare organization, and they're exceedingly more difficult to deal with for small independent physician groups.

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3 comments on "Physician Independence Not Incompatible With Reform"


Patrick Watterson (1/30/2012 at 12:49 PM)
As part of one of the few Physician/PA/NP owned practices in the Triad are, we are seeing many practices join hospitals. This is not always good for the community as the hospital needs admissions and ancillary services from these employed providers. Instead of a CT we can do in office for $700, the hospital is happy to do it and bill for $2500. One of the best things about our practice is we can change quickly where as larger practices/hospitals have to go to 8 committees to make a decision. Employment is not the cure for all that is wrong with health care.

bob (1/30/2012 at 9:21 AM)
Independence is no longer a viable option for the long run, but there are other ways to go besides employment by a hospital or any other organization. the best way is to form a real group practice organization, governed and managed by the members of the group. Such groups can contract with hospitals and health systems without losing control. Go group practice!

Nathan Kaufman (1/29/2012 at 10:32 AM)
Lack of scrutiny and Not being a cog in a wheel (a wheel that is hopefully led by physicians) has resulted in a health care system producing highly variable quality, abusive practices by a significant minority of providers, astronomically high costs, poor access and poorly coordinated care. Talk to the physicians Mayo or Virginia Mason about their impression of the highly fragmented independent physician model! Under an employment model you have to worry about how a bigger machine works.. not just the practice but the community's healthcare delivery system. And the scrutiny is coming regardless of if you are employed or not... tiered networks, value-based compensation for physicians etc. I wonder why Kaiser is one of the fastest growing health plans in the Fairfax area!!!!