Private medical practices aren’t nearly as common today as yesterday. The numbers speak to this fact. According to a study conducted by the American Medical Association, as recently as 2012, private practices represented the majority of physicians in the U.S. Today, just 47 percent of doctors have ownership stakes – a 6 percentage point decline over six years.

Adherents of the consolidation say it’s necessary; unification – they contend – enables the more cost-efficient exchange of electronic medical records, as the average patient has multiple points of contact for primary, preventive and rehabilitative care. Joining forces can improve health outcomes and use of resources, thus creating a smarter business model. Independently minded physicians are fighting back, though, and Tangible Solutions can provide the tools you need to share data while staying at an arm’s distance.

“Hospital physician employment has risen 11%.”

5,000 independent practices subsumed in 12 months

Although closures have happened, and more could be on the way, the decline in physician independence occurs mainly by mergers and acquisitions. In fact, based on a report from Avalere Health and the Physicians Advocacy Institute (PAI), approximately 5,000 independents were acquired by hospitals between July 2015 and 2016.

Hospitals also saw physician employment spike during this period, up 14,000 for a growth rate of 11 percent, the report said. Robert Seligson, CEO of the North Carolina Medical Society and PAI president, said this trend is fairly uniform across the country, with hospital-employed physicians up 63 percent since 2014. “As payers and hospitals drive consolidation across the healthcare system, it is becoming more and more difficult for a physician to maintain an independent practice,” Seligson explained.

Of course, hospital acquisitions aren’t necessarily a bad thing. They can serve as opportunities for networking and an expanded patient base. Additionally, as noted by Dr. Kenneth Christman, a Miami Township, Ohio-based plastic surgeon, hospitals have a greater amount of clout so they’re well-positioned to negotiate better compensation rates with insurers, the Dayton Daily News reported. However, there are downsides to joining hospital networks that can prove challenging. One of which is burnout – it tends to worsen with higher patient loads and bureaucratic hurdles. In fact, according to a study by Medscape, 49 percent of physicians in healthcare organizations attest to the stress and strain associated with burnout, more than any other setting. The least likely to feel worn out by their duties are physicians in solo practices.

Non-compete restrictions rankling physicians

Add a dash of non-compete restrictions to the mix, and you have a recipe for frustration and vexation. This explains why dozens of physicians are fighting back. For example, as reported by The Charlotte Observer, in 2018, 92 physicians employed by Atrium Health filed a civil suit against the healthcare organization, arguing that it took monopolistic actions that impeded the doctors’ ability to compete in the free market, and in the process, harmed patients by reducing their access to the proper care.

Atrium Health has since agreed to the doctors’ breakaway wishes the Observer reported. Why? It may be because they know non-competes are unenforceable and the technology exists that enables practicing physicians to exchange data despite being outside of the system. In short, they have no leverage. There’s no denying that interconnected hospitals serve a purpose and are a key spoke in the healthcare management wheel. But they’re not for everyone, and as the AMA states, physicians should – indeed, must – have the ability to choose the settings they work in best, providing options for themselves as well as patients.

Even though independent practices are increasingly fewer in number, don’t be fooled by the naysayers – you can retain your independence and share data simultaneously. Tangible Solutions can help make this possible by enabling the functionality of information sharing through  data exchange capabilities, such as integration-as-a-service, EMR hosting, or other electronic health data integration methods. In short, Tangible is here to help you retain your independence. Contact us to learn more.


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