One in three independent practices to rely on subscription fees

Analysts predict that the ranks of truly independent physicians will continue to dwindle as the burdens of running a medical practice drives the majority of doctors toward employment. According to a new report from Accenture, only 39 percent of physicians in the United States practice independently in 2012, and that figure will likely drop to 36 percent by 2013.

Of this remaining minority, Accenture predicts that one in three will resort to subscription-based models, such as concierge, direct-pay or online consultations, to sustain profits. Based on market analysis combined with a May survey of 204 independent physicians, the firm expects such models to increase 100 percent annually for three years.

With the expense of running a medical practice ranking as the top reason (87 percent), physicians fled independence. Physicians who resist employment are forced to find ways to reduce overhead and enhance revenue, according to the report.

"Subscription-based practices have the potential to do both," the report noted. "Doctors who convert to subscription-based models that shift the focus away from service volume will not only access greater financial rewards but will also gain the flexibility to get back to the basics of patient care," the authors continued.

Some physicians, on the other hand, have achieved these goals without subscriptions. For example, a recent article from the Star Tribune profiles Minnesota family doctor Christopher Wenner, whose adoption of the Ideal Medical Practice model separates him from the majority of physicians in the state who essentially work for one of three big corporations, including the Mayo Clinic. After leaving a large group practice in 2009, Wenner kept his new two-room practice afloat not with membership fees, but by keeping overhead to a bare minimum and forgoing a salary for months. At the same time, he invested in state-of-the art electronic medical records and became accessible to patients by phone and email.

Now that the "lean years" have passed, Wenner told the newspaper that during a typical "full day," he sees 10 patients, covering his costs after just two. He said he is also "free to make decisions without a committee."

To learn more:
- see the statement from Accenture
- read the report
- see the article from the Star Tribune