Healthcare consolidation forces physicians to make tough choices

Healthcare consolidation may be on the rise, but that doesn't mean being part of a large group works out for every physician. On the coast of Maine, for example, nearly 90 percent of practicing physicians work for medical groups such as Appledore Medical Group, Core Physicians in Exeter and Wentworth Health Partners in Dover; but for various reasons, many physicians who join such organizations opt not to stay, according to an article from

Despite the benefits of employment, including health and malpractice insurance, some physicians dislike having to conform to a new employer's expectations. But physicians who enter into employment contracts are often bound by noncompete clauses, effectively forcing them to relocate if they change their minds about working for someone else.

"I see a big transition to practices like this across the Northeast," Douglas Desantis, M.D., an internal medicine physician who relocated from Maine to North Carolina in 2013, told the newspaper. "This is reflective of the economics of medicine. And these practices seem to have a high turnover. Look at Partners at Mass. General in Boston."

Indeed, physicians throughout Massachusetts watch their colleagues retire early or relocate, according to Katherine J. Atkinson, M.D., who runs a small family practice in Amherst. "I'm seeing that every day," she told Vital Signs, the member newsletter of the Massachusetts Medical Society. "In our area, most of the primary care docs have left practice or left the state. They're either doing cash-based practice or selling alternative things or they've gone to work for systems that can salary them like the VA," she said.

For other doctors, such as Patricia Locuratolo, M.D., a neurologist with a former practice in Portsmouth who was not willing to change the way she practiced to become employed nor logistically able to relocate, the only choice left is to leave clinical practice altogether. Although leaving her patients was difficult, the doctor told Seacoastonline that she hopes to influence systemic healthcare changes through her new position as a state representative.

To learn more:
- read the article from
- see the Vital Signs article