13-employee orthopedic practice could be headed for bankruptcy


Andrew Bush, MD, of Central Carolina Orthopaedic Associates in Sanford, N.C., hasn't seen his practice profit since at least 2018, Kaiser Health News reported Oct. 13. As an independent physician, he's one of many feeling the pressure of growing hospital systems buying smaller practices and attracting surgeons.

Before the COVID-19 pandemic hit, Central Carolina Orthopaedic Associates saw as many as 1,000 patients monthly, but now Dr. Bush is worried about going bankrupt.

The practice received $300,000 in federal COVID-19 aid, but Dr. Bush paused most in-person visits and had to cancel surgeries at the start of the pandemic. While the money helped support his 13 employees, it didn't cover the losses from canceled visits and surgeries. 

Dr. Bush told KHN he couldn't retire since the practice is in debt. Visits have recovered to only half of pre-pandemic levels since residents are struggling with inflation and can't afford the cost of a doctor's visit. 

Selling the practice is on the table for Dr. Bush, but a preliminary offer from a hospital system was rescinded.

Independent physician practice isn't something Dr. Bush would recommend for younger physicians.

"If I could go back 30 years, I wouldn’t become a doctor," he told KHN. "Looking back at life, this was the wrong choice."

Safety risks and fatigue caused by COVID-19 played a role in some physicians selling their practices to large health systems, but distribution of pandemic aid was another major factor. According to KHN, grants and loans were disproportionately sent to wealthy institutions that didn't need the money as much as independent practices and rural hospitals. This allowed some large chains to reap bigger profits and pursue mergers. 

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