Expert: Physicians who move to health system employment must preserve family medicine roots

Woman with Doctor
As more doctors shift to employment by larger health systems, it's important to recognize the need for robust primary care.

More primary care physicians are moving to larger health systems, a trend that raises concerns over whether they can replicate the outcomes seen in small, physician-owned practices.

Thus, as health system integration continues, it’s important to preserve the robustness of primary care, Robert L. Phillips Jr., M.D., vice president of research and policy for the American Board of Family Medicine writes in the September issue of Family Medicine.

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“These findings about increasing migration of primary care physicians to larger health systems and hospital employment, are concerning as they may reduce ability of primary care to deliver the functions associated with better outcomes seen in small, physician-owned practices,” he says.

The year 2016 marked a tipping point for physician practices, as practice owners are no longer the majority, a survey by the American Medical Association found.

Working in integrated systems could enable primary care to become more robust and effective, but Phillips worries that it is “often incentivized to shore up a pipeline of patients to more lucrative services.” He argues that employers must understand and respect the power of primary care to improve outcomes and lower healthcare costs.

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Growing evidence indicates that family medicine teams, which increase the scope of practice for doctors, support better primary care and improve outcomes, he says. A preliminary analysis of the 2016 American Board of Family Medicine Graduate survey, which is sent to all diplomates three years out of training, suggests that broad scope of practice that allows them to work to the top of their training may protect doctors against burnout, which is estimated to impact 54% of doctors, according to Phillips.