American Doctors Leaving Private Practice for Hospitals

The report predicts that next year the number will drop further, to 33 percent, and represents a 10 percent decline from Accenture’s 2012 report.

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A growing number of U.S. doctors are leaving private practice for hospital employment. Just one in three doctors will remain independent by the end of 2016, according to a survey of 194 independent U.S. physicians.

Conducted by Accenture, the survey revealed the number of independent physicians has declined over the last several years, from 57 percent in 2000 to 49 percent in 2015.

The report predicts that next year this number will drop further, to 33 percent, which represents a 10 percent decline from Accenture’s 2012 report.

"Several independents use health care IT to differentiate their practices or to establish new business models," Kaveh Safavi, global managing director of Accenture’s health business, told eWEEK. "One common use is in self-service solutions that put responsibility into the hands of patients and often lower admin cost. For example, Accenture’s forecast found nearly two-thirds of patients will self-schedule appointments by the end of 2019, generating $3.2 billion in cumulative savings."

Safavi also noted health care IT also has potential to establish new business models, such as subscription-based or ancillary services.

For example, One Medical offers a subscription-based service that provides same-day appointments, online prescriptions and email access to doctors for approximately $200 a year.

Physicians’ two biggest concerns about remaining independent are reimbursement pressures and overhead cost, cited by 36 percent and 23 percent of respondents, respectively.

With that, some independent doctors are choosing to opt out of public programs, such as Medicaid (cited by 26 percent of respondents), health exchange plans (15 percent), and Medicare (3 percent).

Independent physicians also are creating new business models to remain competitive.

Nearly one-fifth (17 percent) of those surveyed are participating in accountable care organizations and 7 percent are aligning to patient-centered medical home models.

In other cases, nearly a quarter (24 percent) are considering ancillary or subscription-based services to generate new revenue streams over the next three years.

Meanwhile, in response to revenue and cost pressures, other independent physicians are experimenting with low staffing models, such as reducing support personnel (22 percent) or extending office hours (21 percent).

"There’s increasing complexity to running a solo practice that is often eased with the scale of being employed. The draw to self-practicing medicine used to be about autonomy-- both clinical and business," Safavi said. "Although self-employed doctors can still tune their business model as they see fit, the clinical side of autonomy has been challenged by a certain level of standardization, so it remains no more prominent in solo practices than in mainstream health systems."