In an increasingly hospital-dominant environment, independent physicians fight to hold on, faced with daunting administrative work, payer negotiations and more.
Make-up of the independent physician
1. Down from 57 percent in 2000, the number of independent physicians will continue to decrease to 33 percent by the end of 2016.1
2. Thirty-five percent of male physicians are in private practice, compared to 59 percent who are employed.2
3. While 72 percent of female physicians are employed, 23 percent are in private practice.
4. Of nearly 5,000 physicians, a handful of physicians younger than 40 years prefer employment (23 percent) compared to those who chose self-employment (11 percent).3
5. Of those physicians aged 40 to 54 years, 40 percent are employed and 44 percent are self-employed, the Medscape survey found.
6. Thirty-six percent of physicians 55 years and older are employed, compared to 45 percent who are self-employed, the Medscape survey revealed.
7. The majority (92.07 percent) of physicians chose employment over private practice in 2015 out of necessity.4
8. Among currently self-employed physicians, 13 percent were previously employed; at the same time, 27 percent of employed physicians were previously self-employed.3
9. Independent physicians possess stronger incentives than hospital-employed physicians to prevent hospitalizations, according to a 2016 Harvard Medical study.5
Maintaining independence
10. Seventy-three percent of independent physicians said they would like to maintain independence, if their practices were profitable.6
11. The "2015 Independent Physician Outlook Survey" also found, however, 44 percent of physicians said they will probably sell their practices within the next decade.
12. Nearly all — 94 percent — of independent physicians said the industry should seek new practice models so independent practices can stay afloat in a changing healthcare economy, according to the "2015 Independent Physician Outlook Survey."
13. Three-in-five physician owners do not plan to sell or merge. Those physicians who are planning to sell or merge are largely driven to do so because of administrative work.7
14. The following represent factors allowing physicians to stay independent in some markets.6
• Stable reimbursement — 45 percent
• Steady referral stream — 53 percent
• Specialized nature of practice within the local healthcare community — 70 percent
• Efficient and sustainable cost structure — 50 percent
• Other — 10 percent
15. Specialization proves key to survival, as 70 percent of independent physicians reported the "specialized nature of their practice within the local healthcare community" allows them to survive.
16. Hospitals and health systems are shifting focus from acquiring other hospitals to purchasing clinics and physician practices, according to an Accenture report. By 2018, it is expected that vertical acquisitions of clinics or physician practices will reach 84 percent of the total provider acquisition model.
Finances & satisfaction
17. In primary care, self-employed physicians ($229,000) make more than employed physicians ($207,000). Similarly, among specialists, self-employed physicians ($348,000) make more than employed physicians ($274,000).2
18. Sixty-three percent of self-employed physicians reported being happy, compared to only 55 percent of employed physicians.3
19. Of self-employed physicians, 73 percent report satisfaction with their careers.
20. In 2015, the majority of physicians who were sued practiced in office-based solo practices (70 percent) and office-based single-specialty groups (65 percent).8
References
1. Accenture: "The (Independent) Doctor Will NOT See You Now"
2. Medscape Physician Compensation Report 2016
3. Medscape Employed Doctors Report 2016: Who's Happier: Employed or Self-Employee Doctors?
4. The Medicus Firm, "Most Frequently Placed Specialties, Signing Bonus Trends, and More Revealed in New Placement Report"
6. ProCare's "2015 Independent Physician Outlook Survey"
7. CareCloud's "Practice Profitability Index" report
8. Medscape Malpractice Report 2015: Top Reasons Doctors Get Sued