Practice Points
By Laurie Morgan, Capko & Morgan
Physician attitudes about private practice ownership
In July’s Practice Points, I shared experiences my partners and I have had that suggest the media hype about consolidation in healthcare may be omitting a big part of the story. We’re still hearing regularly from physicians who are contemplating opening practices – and from others who wonder if joining up with larger organizations will ever deliver on its promises.
But, of course, compelling as they seem, these anecdotes represent a small, self-selecting subset of all doctors. So we’ve been hoping for an opportunity to get our hands on more data on the subject.
That’s why we jumped at the opportunity to do an email survey on physician satisfaction with practice settings with MedData Group in September. More than 250 physicians from more than 20 specialties responded, ranging in age from recent graduates to doctors who’ve been practicing 30 years or more, in locations all around the US.
While the respondents’ backgrounds and employment settings were diverse, their responses showed fairly similar attitudes about private practice ownership – and those feelings are quite optimistic.
We asked respondents to rate their agreement with the statement, “Private practices offer physicians satisfying career opportunities.” Eighty percent of practice owners responding either strongly agreed or somewhat agreed. And even the employed physicians leaned positive, with 61 percent either strongly or somewhat agreeing. Only 10 percent of the practice owners and 15 percent of the employed doctors disagreed.
Optimism worth acting on
For a significant chunk of the employed respondents, their positive attitudes aren’t purely hypothetical: 20 percent said they are considering practice ownership in the future. And 8% said they plan to start a new practice in the next three to five years. According to the Small Business Administration, about 1.2 million new employer firms were launched in the U.S. from 2011-2013 – well under one new firm for every 100 Americans. That pegs the entrepreneurial plans of our employed respondents at more than eight times higher than Americans as a group.
Revealing comments
Our survey clearly struck a nerve. Besides rating their attitudes about private practice ownership, more than 50 percent shared free-text comments.
Not surprisingly, many voiced familiar concerns about challenges private practices increasingly face. Government interference (31 percent), pressures from insurance companies (21 percent), revenues growing slower than expenses (17 percent), and billing and other management challenges (10 percent) were commonly noted as obstacles to profitable private practice ownership.
But other comments at least partially explain why many physicians still want to own practices – and why they don’t seem very likely to waver in that preference. The ability to set policies without interference from non-physicians was cited by 25 percent of the commenters; another 8 percent said that ownership allows physicians to establish better patient relationships.
Regarding this last point, there is a growing realization in some corners of healthcare that it is harder for larger organizations to deliver better care than smaller ones. The personal touch matters in medicine, perhaps more than in any other field. Physician quality of life does, too: We all need motivated doctors to serve growing healthcare needs. One of our respondents said that owning a private practice is “the BEST career on the planet.” No wonder so many doctors aren’t really buying the idea that practice ownership is going away, and so strongly oppose the forces that threaten it.