The Vanishing Private Practice Physician

Sunday, February 23, 2014 // Uncategorized

Vanishing from America–The Private Practice Physician


 Posted Monday, February 17th 2014 @ 5am  by Jim Forsyth



One of the iconic images of Americana….the physician with a private practice on Main Street….is fading into history, and there are several reasons why doctors are electing in greater and greater numbers to abandon private practice and opt for salaried jobs with physician groups and hospitals.


But 1200 WOAI news reports that more and more, Dr. Marcus Welby is morphing into Dr. Big Corporation.


Dr. Stephen Brotherton, the President of the Texas Medical Association, says the rush away from private practice is not happening in Texas at as fast a pace as in other states, but it is still a cause for concern.


“There is more upheaval in medicine,” he said.  “There is a lot more uncertainly about being able to earn the same income, and there are a lot more regulations, and it is becoming more and more difficult to keep up with them.”


A physician placement group reports nearly two thirds of doctors who are changing jobs or entering the work place for the first time following medical school, opted for salaried jobs with hospitals or physician groups last year.  As recently as 2004, that figure was eleven percent.


Dr. Brotherton says Obamacare is one factor speeding the exodus from private practice, but he says paperwork requirements have been growing for the last several years.  Many doctors say they now spend as much as one third of their total work day not treating patients, but on the phone with insurance companies and with federal government bureaucrats negotiating treatment.


He says another factor influencing young doctors’ job decisions is the huge amount of college loan debt they have today when they get out of medical school.


“Doctors are coming out with a lot more expense, so if they have steady income rather than something that is less predictable, they may find that more appropriate,” he said.


The impact of this move will be…you guessed it…higher costs for the patient.  Analysts say when the doctor is an employee of a hospital, for example, hospitals will tack a ‘fee’ onto the doctor bill four routine testing, or for other procedures that have been routinely included in the bill for the exam.  Some hospitals even charge for the tongue depressors and rubber gloves which have previously been simply a part of the visit to the doctor.


Brotherton says the Texas Medical Association realizes the importance of the private practice physician hanging out his or her shingle on Main Street and treating members of the same family for decades.   He says several programs have been implemented to help private practice docs overcome the hurdles which might otherwise push them toward a hospital or medical group.


“TMA has developed a physician service organization, a PSO, designed to help docs who are still in private practice with some of these questions and some of these regulations,” he said.


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