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The “stampede” of physicians from private practice has Reed Wilson, M.D., a Beverly Hills-based cardiologist and internist, up in arms.
Indeed, the future of independent practice looks bleak. A survey released yesterday finds that 38 percent of U.S. physicians are now employed by hospitals and health systems.
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And the Affordable Care Act--with its increased need for quality measurement and reporting--is to blame, according to Wilson, in a commentary in Forbes.
"The bottom line is that the Affordable Care Act makes private practice a financially infeasible option for thousands of doctors. But patients--and policymakers--need to ask: Does the death of private practice actually cut costs and improve quality? The answer is too often 'no,'" he writes.
The essence of the doctor-patient relationship is often lost when physicians move to larger practices or hospitals, he says. Interactions under those conditions are too often guided by rote formulas and directives devised by administrators.
As Wilson sees it, the result of ACA initiatives, such as accountable care organizations, is worse health outcomes. He cites a 2014 Commonwealth Fund study that shows patients treated at small private practices end up in the hospital with preventable illnesses far less often than do patients served by larger practices.