The Disappearing Independent Physician

In a recent post I noted the trend among physicians to sell their practices to hospitals.

The recession coupled with the passage of the healthcare reform initiatives has pushed many physicians into simply throwing in the towel and walking away from the independent practice model.

This month in Smart Money is an article entitled Say Farewell to the Family Doctor.  It's an interesting read.

The articles continues the discussion about physicians becoming employees of hospitals and describes the impact this change is having on the physicians, patients, and the economics of medicine.  

I enjoyed the article, but the last paragraph really gripped me. Here it is:

Still, Mikell acknowledges, "doctors don't want follow-the-directions, cookbook medicine." And for many physicians, the idea of following new rules triggers a much larger unease at giving up their independence—a feeling of loss, both for the businesses they built and for their patients. Back in Bozeman, Blair Erb, the sole cardiologist in town, is a picture of resignation as he prepares to sign a contract with Deaconess. "I feel defeated," Erb says, looking around at the office furniture he and his wife, Liz, chose from a catalog years ago. The weathered ranchers and bundled-up women that come through his door mostly express disbelief when they hear that this frank-talking Tennessee native will sell his practice. His staffers say they're not looking forward to the questions the hospital's medical records system will soon prompt them to ask patients. (Do you wear a bike helmet regularly? Do you have a smoke detector?) "We'll try to retain as much professional independence as possible," Erb says, gazing at the hospital building, whose bulk he can see through his window. "But the fact of the matter is, we'll have a new master."

This paragraph was especially poignant to me since Dr. Erb is a former president of the Wilderness Medical Society and an author in our Expedition & Wilderness Medicine textbook.  

Regardless of one's stance on all the healthcare reform initiatives, it is difficult to watch this generation of physicians enter the twilight of their careers with frustration and disappointment. These men and women-- and their loyal patients-- deserve better, and our society will soon feel the impact of the loss when they and  their practices are gone.  

Update on Apr 15, 7:42 AM by Greg Bledsoe MD

Note:  I wanted the readers to be aware of a correction to this post.  The Dr. Blair Erb who is mentioned in the Smart Money article is the son of the Dr. Blair Erb who was the president of the Wilderness Medical Society and an author in our Expedition & Wilderness Medicine textbook.

Comments

[Arlen D Meyers, MD, MBA]

One in six doctors in the US is employed by a healthcare organization. This is being driven, in part, by attempts to capture reimubursement for accountable care organizations and revenues derived from technical fees. What you failed to mention is the resultant rising costs and issues resuliting from market consolidation. How it plays out is anybody's guess, but I wonder what the collateral damage will be to innovation, medical education, manpower supply and the "patient expereince" when the money runs out and we try something else.

[Greg Bledsoe MD]

Good point, Arlen. It will be very interesting to watch this all play out over the next few years.

[Blair Erb]

You need to check your references more thoroughly. It is my father who was president of the Wilderness Medical Society.

[Greg Bledsoe MD]

Thanks for the clarification, Blair. Please tell the other Blair Erb we said hello.