The demise of small practices? Not so fast

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Despite the pressures on small practices in the current healthcare environment, physicians who do not wish to become part of a larger practice have options and resources, according to a blog post from the American Academy of Family Physicians.

In the post, AAFP Board Chair Robert Wergin, M.D., says he’s declined more than one offer to consolidate his practice into a larger organization, bucking a persistent and accelerating trend that’s seen a rise in large practices and a decline in the number of smaller ones. Given a survey in the Annals of Family Medicine that showed over half of family physicians worked in practices with fewer than five doctors, as well as studies demonstrating the ways small practices can reduce costs and raise care quality, the blog post suggests reports of the imminent demise of small practices might well be overblown.

Wergin suggests physicians who want to remain in small or independent practices take the following steps:

  • Use your own work style to decide on the ideal size for your practice, an approach that Wergin says makes more sense than looking at financial or technology concerns.
  • Get proactive about figuring out how to deal with value-based payment schemes. As the article notes, the smaller patient panels covered by smaller practices mean as few as two high-cost patients could reduce overall quality scores.
  • Seek out opportunities to band together in “virtual groups” or independent networks that allow smaller practices to enjoy some of the benefits of a larger pool of information without losing their autonomy.
  • Take advantage of tools such as the Transforming Clinical Practice Initiative developed by the Centers for Medicare & Medicaid Services to provide small practices with learning networks at the state level in order to assist them in partnering with other practices to boost their quality of care.