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Physician Independence Not Incompatible With Reform

Philip Betbeze, for HealthLeaders Media, January 27, 2012

I'm not sure that the majority of his professional peers agree, but it's nice, as a healthcare consumer, to know that there still is a choice. For now, even Libby agrees that independence appears to be the tougher road in the future, albeit a more rewarding one.

As an independent physician, you can't afford to sit on the sidelines as the industry changes, he adds. And he concedes that while employment could be the right choice for some physicians, there are big downsides.

"If you're employed you're much more a cog in the wheel," he says. "You don't have to worry about how the machine works, and you are insulated. But you're going to be scrutinized in ways you haven't been scrutinized before, which will directly impact your compensation."

Libby, a pediatrician in a 16-clinician multispecialty practice in Fairfax, is, with his partners, in the process of evaluating a potential business partnership with a local hospital. But the deal would stop far short of employment.

"You have to face the fact that you have to develop an approach to team care and understand how to evolve systems that don't necessarily stratify and create questions of authority and that are geared toward solutions," he says of the effort.

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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!!!!