Report shows decline in independent physicians.

AMA REPORT     (11/19, Elliott) reports, “Numbers released Oct. 31 by the consulting firm Accenture showed a decline in doctors who operate independently. Business pressures were listed as a major reason why physicians were willing to trade the autonomy of independent practice for the perceived comfort of employment.” In fact, “only 36% of practicing physicians will hold a practice ownership stake by the end of the 2013, down from 57% in 2000, according to Accenture’s analysis [pdf] of data from the American Medical Association and MGMA-ACMPE.”

Tropicana Forum Medical Commentary by Paul Goldfinger, MD, FACC:

In recent articles, we have pointed out that there is already a shortage of practicing doctors and that shortage will get worse.  We predicted  that many doctors will give up their independent practices in exchange for salaried jobs  (i.e. “employment”) and that these doctor issues will profoundly impact the quality  of care under the ACA.  That is why we keep talking about it.

In the study above, the numbers are revealed, and you can see that the phenomenon described is accelerating at an astonishing rate. This observation goes to the issue of availability of care.  When doctors say that they are seeking “the comfort of employment,” it means that they don’t want to work so hard.    I have personally discovered, and discussed here, my own discouraging experiences trying to find a quality primary care doctor.

In searching for one recently, three in New Jersey’s Monmouth County were recommended to me by other doctors. I called them all.  One only works 2 1/2 days per week. The other just had a baby and will resume taking new patients in February.  She also will only work a few days per week.  The third doctor was setting up a boutique practice where he will have a limited number of patients, and they will pay an extra yearly fee for his care. My current primary doctor is closing his doors. So I currently don’t have a primary doctor, and I’m beginning to think that I don’t want one.  More on that subject subsequently.

As I pointed out before, these observations, both local as well as reported nationally by the AMA, confirm that when the Affordable Care Act kicks in with 30 million new patients, there will be serious trouble with doctor availability.  This past week, the administration announced some new regulations regarding the ACA, but so far we have not learned what they hope to do about the doctor shortage.

Interestingly, another study just showed that most  poor people who would benefit from insurability under the ACA are totally clueless about what will be available to them in regard to new health coverage.  Maybe that’s the cure for the projected doctor shortage:  don’t tell those eligible for care about the ACA.*

*   From the Washington Post    (Washington Post article Nov 21, 2012 )  :   “..a growing body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what’s coming.”