Many employed docs say non-physician practice ownership cuts quality, survey finds

Nearly 60% of doctors who practice as employees of hospitals and other corporate entities say that non-physician practice ownership results in lower quality patient care, per a new survey. 

The 1,000-physician poll was conducted by the National Opinion Research Center at the University of Chicago and was commissioned by the Physicians Advocacy Institute. It aimed to examine the experiences of docs employed by hospitals and health systems, VC and private equity firms, payers and staffing agencies. 

Most docs surveyed cited decreased time with patients and greater focus on financial success as elements negatively affecting quality at non-physician-owned medical practices, with 70% saying their employer uses incentives or penalties to have them see more patients a day.

Less than a fifth of respondents felt that the growth in corporate ownership of medical practices has improved care quality. This group cited greater investment in infrastructure and technology and increased focus on patient-centered outcomes as the key benefits of corporate ownership.

The findings exemplify the widely held belief among many employed docs that corporate ownership may erode key aspects of the patient-physician relationship and impact patient outcomes, the Physicians Advocacy Institute said.

“The patient-physician relationship is the foundation of our healthcare system,” Kelly Kenney, CEO of the Physicians Advocacy Institute, said in an announcement. "With corporate ownership comes a higher emphasis on financial outcomes and shareholder returns. This focus on the bottom line can interfere with best clinical practices.”  

Employed docs in the survey cited concerns about several corporate owner policies. Sixty-one percent said they have moderate or no autonomy to make referrals outside their practice or ownership system. Nearly half (47%) reported policies or financial incentives to adjust patients’ treatment options to reduce costs, including lower-cost drug therapies. 

Those who moved from private practice to employment did so to achieve more work-life balance and better pay, the survey revealed. More than half (55%) reported continued satisfaction with their decision to transition away from private practice. 

Docs also expressed frustration around having minimal say in practice management policies, burdensome EHR processes and issues of hiring and admin support. And 60% said they had to sign a non-compete agreement limiting their ability to practice locally if they were to leave their employment. Nearly half said they would consider joining a union, were it an option.

“As the structure of medical practice fundamentally changes, healthcare leaders and policymakers have a responsibility to make sure patients and their physicians remain at the center of health care,” Kenney said in the press release. “New insights on the employed physician landscape can shape crucial policy decisions in the future.”