Something I think we may have all noticed...it is a lot of work to have a life and maintain the solo practice these days, and I prefer a solo practice MD myself...but do see the trials and tribulations it can have, not to mention not being able to have much of a life...BD
A survey released in August by the Center for Studying Health System Change found a marked increase in the percentage of doctors joining large, single-specialty groups, as well as entering employed situations. The survey, covering 1996 to 2005, also found a marked decrease in the percentage of physicians in solo or two-doctor practices, as well as a large drop in the percentage of doctors who have an ownership stake in their practices. The finding was especially apparent among older physicians.
Observers say this trend is not going away anytime soon and might well reflect a growing cultural change among physicians.
"The first wave [in the mid-1990s] was selling the doctors on being employees. You remember the whole herding cats thing," Miller said.
"Today, you have a lot of doctors, a lot of them specialists, who actually are coming to the hospital and saying, 'I'm sick of dealing with malpractice, I'm sick of fighting for reimbursement, I'm sick of dealing with a fractious staff -- just hire me.' "
AMNews: Sept. 10, 2007. Finances driving physicians out of solo practice ... American Medical News
Au contraire, I believe the solo practice is undergoing a renaissance. It is called the micro practice and integrated EHRs are making this possible. A recent article by a Dr. Egly (who uses e-MDs I believe), stated that he has an overhead of around 35% (as I recall) and it is just him and his wife. In reality, if the physician can use technology to automate the charting AND billing/posting, then it becomes possible to have a very lean solo or two provider practice and avoid the headaches and politics of a group practice.
ReplyDeleteYou make some very good points indeed here. Technology can keep the solo practice going, but those who continue to rely on old paper methodologies are the ones with issue I feel as well. I preach this all the time to the small practices myself and many times over I am impressing the exact same thoughts....use technology and grow your business or go find a salaried physician job, as in time I think the margins will narrow even more as the small practice cannot afford the additional man/woman power to exist as our health care system evolves, but technology can give you the power with electronic record keeping.
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