Who Says the Independent Practice is Dead? 58% of Physicians Don’t Want to Sell

Maybe, to quote Mark Twain, the description of private practice being dead is premature. Dependingon the geographic area, the insurance coverage, the mindset of the physician owners and a variety ofother economic issues, private practice still has a significant place in the medical community. An analysisof alternatives is always appropriate even when there’s no offer on the table. Understanding where yourbusiness model might take you and what might impact your profitability and ability to stay in practice isgood business planning.

Market forces such as declining reimbursement, rising technology costs and pressure to consolidate may be pushing physicians out of independent practice.

But that doesn’t mean they have to go willingly.

A new survey of 2.094 physicians who own their own practices found that 58% are not looking to sell. Just 11% said they’re looking to sell, while 10% had already sold, according to the survey’s sponsors, health information technology firms CareCloud and QuantiaMD.

Solo practitioners are the most committed to staying independent. Specifically, 65% of solo practitioners say they’re not looking to sell. That number declines to 64% of practices with between two and nine providers, 46% with between 10 and 25 providers, and 42% with between 26 and 49 providers.

At practices with 50 providers or more, the number again rises, with 61% uninterested in selling. The report doesn’t provide a full breakdown of the numbers by specialty, but does note that pediatricians are among the least likely to want to sell (68% don’t want to), while cardiologists are among the most likely, as only 44% say they’re not looking to sell.

So why do physicians who practice independently want to stay that way? In general, they value their autonomy and long-term relationships with patients, according to a report from health IT firm McKesson.

“We really are wanting to be patient oriented and not bottom-line oriented,” family practitioner Warren Miller, MD, told McKesson. “Most every place has the label of some hospital organization on their door. And we don’t. It’s hard, it’s kind of swimming upstream.”

A report from consulting firm Accenture last year illustrated that physicians are indeed having a more difficult time in staying in independent. By the end of 2013, Accenture predicts 36% of U.S. physicians will be independent, down from 57% in 2000.

Still, independence is not impossible. To remain independent, physicians should focus intently on maximizing the value they provide to patients, Richard Fu, an Accenture strategy consultant said “Independent practitioners can weather this change in market pressures by enhancing their value proposition to patients,” Fu advised. They need to “focus on the core, personal, attentive care provided to each patient while enhancing their practice with modern technologies expected from large companies.”

Interestingly, physicians who choose to remain independent may be helping existing health insurance companies stay afloat, Lou Goodman, PhD, president of the Physicians Foundation told Medical Economics last month. For physicians, that may or may not be an undesired byproduct of remaining independent.

“Doctors and the health insurance companies seem to be fairly aligned on a lot of issues right now in that if physicians remain independent, the insurance business stays whole,” Goodman said. “If physicians don’t stay independent and become employed by institutions, those institutions will become so vertically integrated that they will be able to self-insure and write their own insurance.”