MGMA18: Dinosaurs? Hardly. A renaissance in independent physician practices, doctors say

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“The two people who care the most about patients are patients and doctors," says Dale Owen, M.D., who led a group of doctors who formed an independent practice in North Carolina. (Rawpixel)

BOSTON—If you think independent physician practices are going the way of the dinosaur, you’d be wrong.

That's according to one group of doctors who say the pendulum—in which doctors were once flocking to hospital employment—is now swinging the other way.

“Our intent today is to create a new national forum for a re-energized sector,” said Michael Nachomovitz, M.D., senior vice president and chief clinical integration and network development officer at NewYork-Presbyterian Healthcare's Physician Services Division in New York.

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Nachomovitz was one of four doctors who shared their experiences leading independent practices at the Medical Group Management Association (MGMA) annual conference in Boston last week. At a time when 47.1% of physicians are employed by hospitals and healthcare systems, there’s a new focus on the independent medical practice, Nachomovitz said: “Consolidation has not delivered on its promise."

Dale Owen, M.D., CEO of Tryon Medical Partners in Charlotte, North Carolina, told FierceHealthcare he thinks the shift has to happen. Owen shared his story of how a group of 88 doctors left Atrium Health to form a new independent practice.

“Physicians are now being called providers. It’s become more corporate, more autocratic,” he said about hospital employment.

Independent practices empower the doctor-patient relationship, he said: “The two people who care the most about patients are patients and doctors.”

As of mid-2015, one in four medical practices was hospital-owned, according to one study. Hospitals acquired 31,000 physician practices, a 50% increase, from 2012 to 2015, according to the report. And 2016 marked the first year in which physician practice ownership was no longer the majority arrangement, with physicians evenly distributed between being owners and employees: 47.1% of doctors own their own practice, with the same percentage employed and 5.9% independent contractors.

But that didn’t necessarily lead to physician satisfaction, Nachomovitz said. A recent study, in fact, found that physicians in small, independent primary care practices reported dramatically lower levels of burnout when compared to the national average.

Patrick Carter, M.D., medical director for care coordination and quality improvement at the Kelsey Sebold Medical Group in Houston, said the practice has gone full circle, from its origins as an independent practice in 1949 to its sale to a physician management company to ownership by a hospital and back. “I call it the long and winding road to independence. … We are independent, for-profit and physician-owned,” he told the conference audience.

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Being an independent practice allows doctors to control their destiny, said Robert Kent, D.O., president of Unity Health Network in Cuyahoga Falls, Ohio, a collaboration of 90 physicians. It is northeast Ohio’s largest independent physician network offering primary care services and specialty care.

Being independent has allowed the network to improve quality and increase both patient and physician satisfaction, he said. To succeed as an independent, a practice needs to have a truly aligned physician culture, as well as a sophisticated and supported infrastructure, he said.