The paramount question that nearly all physicians have been asking themselves is, "Where do I want to work?" Just six words, but it's an extremely complicated question.
As the turbulence of healthcare reform forces change, almost every doctor in the nation is pondering some version of a question like this one and wondering about their future. Self-employment? Form, join or leave a group medical practice? Relocate? Become an employee of a hospital or health system?
And, once their decision has been made, healthcare providers can consider the opportunities and dangers that remain. How has the competitive landscape changed? What assumptions and constants have disappeared? And what adjustments are needed in the marketing plan to remain competitive and survive?
Here are some of the big-picture numbers that are driving change in healthcare today. It's a picture of change on a large scale.
"Mergers and acquisitions in the healthcare industry surged in the second quarter of 2011," reports HealthcareLeaders Media, "setting a pace to break all previous records in the sector."
Within this sector, "$7.3 billion was accounted to mergers and acquisitions of providers, including hospitals ($3.5 billion), managed care ($1.6 billion), long-term care ($985 million), and physician practices ($416 million)." Observers believe the pace is accelerating as hospitals build their accountable care organizations.
One of the main dynamics in this picture, according to a new report from Accenture, is that "community-based physicians-those previously in private groups-are increasingly selling their practices or seeking employment directly with healthcare systems, and hospitals are aggressively acquiring physicians to remain competitive in the industry."
"By 2013, less than a third of physicians will be in private practice, electing instead for employment with larger health systems," comments amednew.com. "The rate of independent physicians employed by health systems will grow by an annual rate of five percent over three years," according to the report.
"Burdened by administrative responsibilities of their private practices, physicians are increasingly attracted to the resources that health systems offer, as well as manageable work weeks and job stability," notes the report."
Data released last month by the Medical Group Management Association (MGMA) indicates that "65 percent of established physicians hired, and 49 percent of those finishing residencies, landed positions in hospital-based practices in 2009. Industry analysts agree that solo and small practices are becoming less common, and more physicians are becoming employed by hospitals and large groups."
We agree in general with the Accenture report that concludes, "how the physician employment trend and its implications will unfold remains to be seen." But clearly, for the solo and small group providers there will be challenges and dangers. Some of these include:
Regardless of where you are in the decision process, we can help you understand your options in a rapidly changing healthcare environment and help you respond quickly to opportunities in the marketplace.