Physicians reluctantly surrender practice independence

Number of hospital-employed physicians increased 75% since 2000
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While a steadfast segment of today's medical practice continues to fight for independence, the pressures to give up practice ownership are becoming increasingly prevalent.

As a recent article from American Medical News described, some doctors report mixed emotions about taking the employment route. "I was not entirely enthusiastic about coming to Aurora [Medical Group of Illinois, a hospital-owned practice]," internist Jay Monahan said. "I had been independent my whole professional life. When a problem comes up, you just cannot give an order to fix it like you used to, but when you have a regulatory beef, that's somebody else's problem. If you're ready to make that trade-off, [a physician] can probably be pretty happy."

Nationally, the United States has seen a nearly 75-percent increase in the number of physicians employed by hospitals since 2000, according to a recent survey from the Medical Group Management Association. Meanwhile, some states, such as Massachusetts, are already seeing employment models take over the vast majority of physician practices, the Worcester Business Journal reported, citing a March 2012 survey from the state medical society showing that 62 percent of Massachusetts physicians worked for group practices or hospitals or were considering making the switch from self-employment.

Adding to the trend, according to the newspaper, is the nation's push toward accountable care organizations, adding that larger medical groups and hospitals are better equipped to make the changes to technology and infrastructure to become ACOs than small, private practices.

Nonetheless, there are still some believers that the independent physician practice can be cost-efficient and profitable. For example, John Kelly, co-owner and physician at Grove Medical Associates in Auburn, Mass., said that practices can align in other ways, such as through independent physicians' associations, to achieve strength in numbers to help keep them afloat.

"If you're doing a good job, you can survive in private practice," said Kelly, who vice president of the Central Massachusetts Independent Physicians Association.

To learn more:
- read the article from the Worcester Business Journal
- see the story from American Medical News

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