The Uptick of Physicians Leaving Private Practice
A recent Becker’s ASC post entitled “‘The Costco-ing of medicine:’ Will consolidation take individuality out of physician care?” lays out a case for the decline of physician innovation in a world of employed doctors. While this claim is likely true, it avoids the broader question of why physicians are stepping out of private practice ranks and into employed roles in the first place. Moreover, it may be moot in the sense that the trend of private-to-employed is not likely going to turn any time soon. PE-led rollups and acquisition by hospital systems and large groups carry enormous momentum. It may be time to focus on how employed doctors and incentive plans can ensure continued innovation rather than spending a lot of time comparing structures.
More than 108,700 physicians shifted to employment from 2019 to 2021, according to an April report from Avalere, and some leaders are concerned about how this is shifting care delivery.
Michael Gross, MD, an orthopedic surgeon based in Hackensack, N.J., recently spoke with Becker’s to discuss how increasing consolidation is affecting the industry.
[Editor’s note: This interview was edited lightly for brevity and clarity.]
Question: What healthcare trend are you wary of in 2023?
Dr. Michael Gross: I’m keeping an eye on consolidation and all these physician practices becoming large-scale, corporate entities, or everybody being owned by hospitals. A lot of people go into medicine because they want to work for themselves, and they have a certain independent streak. As we become a lot more corporate, we lose a lot of individual practices. I think it’s a good thing financially, but I think overall it’s just going to be different. Practice is going to be different.
It is a lot more about compliance in the corporate world. In a private practice, you’re focused on being nimble and making decisions every day. You can look at things and say, “We can do this better, why don’t we do it this way.” You’re constantly striving to be better and to be more excellent. The corporate world looks at it like, “We’re doing this pretty good; let’s not mess with it. It’s good enough.” And people are more worried about even voicing an opinion in the corporate world. Everybody’s always looking over their shoulder.
This whole Costco-ing of medicine is going to take some of the originality out of it. There’s a tremendous amount of innovation and technology. Medicine—I still think it’s a great career—if it’s something you want to do and if you know that doctors down the road are not going to make as much money as guys of my generation. And guys in my generation didn’t make as much money as the guys before us….
Michael Gross, MD