An increasing number of physicians are exiting private practice to join hospitals or other corporate entities, leaving just 26 percent of physicians as independent practitioners in 2022, according to an April report from Avalere.
Three independent spine surgeons discuss how this trend is threatening physician ownership and what the knock-on effects could be for patient care:
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: The corporate practice of medicine is not the solution to what ails our system. Patients over profits should always be the physician's mantra. While it is tantalizing to partner up, go to expensive lunches and sign lucrative deals, it is not worth the sacrifice of autonomy and, very likely, selling the soul of your business. By the time one realizes patients are not getting the same quality of care one would customarily give, it will be too late to change. This, I fear, will be the endgame of our system.
Melanie Kinchen, MD. 360 Back & Spine Center (Grapevine, Texas) and MpowerHealth Clinically Integrated Network (Addison, Texas): The biggest threats to physician ownership are the increasing and ever-changing marketing strategies necessary to compete with large groups and hospital networks. Larger groups and hospital networks obviously have more capital to effectively market using all avenues of social media. More importantly, they are able to control the flow of patients through corporate contracts. These contracts funnel patients into certain networks or hospital systems.
While individuals or practices may have privileges at these hospitals, they are not considered the preferred provider — not because of quality or ability, but because of the exclusion from that relationship. Smaller or individual practices also can't leverage insurance companies the same way larger groups can, so their reimbursement is often significantly less. These factors lead to less patient volume, less reimbursement and less revenue to reinvest in technology upgrades and marketing.
Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): The larger the group, the more corporate they become. Most "corporate" groups depend on high patient volume to keep up with ever-increasing overhead and ever-decreasing reimbursement. The less time a physician has to spend with a patient, the lower the quality of care typically becomes.