Independent, private practices may play a smaller role in the future if young doctors continue the trend of working at hospitals instead of their own practices, according to the Kansas City Star.
In the Kansas City area, 55 percent of physicians are now employed by hospitals, Blue Cross and Blue Shield of Kansas City estimates, according to a separate article from the Star.
The change among the new generation of doctors is attributed to the appeal of flexible schedules and younger physicians making their personal lives a priority over career advancement. The movement also reflects the findings of a 2011 survey by recruitment firm Merritt Hawkins, which reported that senior medical residents rated hospital employment as their top career choice, with just 1 percent of new doctors saying they wanted their own practice.
"I think they are trying to adapt to a system that wasn't sane to begin with. They want greater flexibility to practice medicine, raise a family, serve society," Mark Meyer, associate dean for student affairs at the University of Kansas School of Medicine, told the Star. In the past, he said, "[y]ou were defined [in by your practice, by being a physician. Now you're a diversified individual. I'd argue that translates into better physicians, because they're more well-rounded, more in touch with the communities they serve."
Money's also a factor--healthcare reform pays doctors for quality rather than number of procedures performed, making long hours not as lucrative as in the past. New doctors coming out of medical school in 2013 owed an average of $175,000 in student loan debt. The added $150,000 cost of starting up an independent practice may be too daunting, the article states.
Hospital salaries have more appeal. A starting hospitalist makes about $200,000 a year, while their office-based counterparts earn about $150,000, FierceHealthcare previously reported. Moreover, hospitalists earn those salaries by typically working seven days in a row, then having seven days off. The fact that hospitals offer shift work, meaning no on-call or after-hour duties, is another incentive for physicians, particularly those who are parents or have multiple jobs, according to the article.
New graduates also don't feel prepared to handle the business and financial end of a medical practice, with only 9 percent stating they feel "very prepared" to handle the business aspect of their career, the Star states.
Another factor contributing to the shift toward hospitals is the emphasis on collaboration and teamwork in an effort to increase quality and reduce costs.
"There's been a growing recognition that we can't do what we need to do to reform healthcare delivery without more interprofessional collaboration," Carol Aschenbrener, chief medical education officer of the Association of American Medical Colleges, told the Star. "For doctors to be part of a team, and not always the leader, you must begin early in professional school, before their professional identity is set."