A notable exception to the shift toward employed physician models is the rise in concierge practice. Merritt Hawkins conducted 32 searches last year, up from 10 searches two years ago. Singleton says his search data probably underreports the move towards concierge services because recruiters often aren't needed.
"If you are a provider who is fed up, whether it's your legal costs or compliance or the business of medicine itself, the easiest shift you could make is to become a concierge physician," he says.
The shift also meshes well with the move toward consumer-driven healthcare. "We are seeing some of the same trends in urgent care and freestanding ERs towards convenience medicine," Singleton says.
"People are coming to understand this consumer-driven, convenience care area of medicine and the push to outpatient care. Concierge is a good reflection of that. Healthcare for so long has been insulated to the consumer. They haven't had to appeal to the consumer like they do now."
Speed Bump for Value-based Care
Merritt Hawkins' report also shows that the move toward value-based physician incentives stalled in the past year. In 2013, 39% of Merritt Hawkins' search assignments offered a production bonus featuring at least one value-based metric such as high patient satisfaction scores or low hospital readmission rates.
In 2014, that number dropped to 24%, which Singleton says indicates that employers are struggling to create physician compensation formulas that incorporate both volume- and value-based metrics.