Physician independence is one of the single largest questions in healthcare. Does it have a future or is physician autonomy a thing of the past?
Medical management consultant company ProCare Systems hosted the 2015 Independent Physician Outlook Survey, which provides insight into that state of independence in the medical field from the physician perspective.
"Given the staggering majority of physicians that desire continued independence, the findings in this survey indicate that independent specialists can no longer take a 'business as usual' approach to their future," said Fred N. Davis, MD, co-founder and president of ProCare Systems. "Physicians can thrive in their practices, rather than becoming employed by larger healthcare institutions, by embracing innovative practice models designed to meet the increasing complexity of today’s healthcare environment while keeping their practices sustainable and profitable."
Here are nine key points on what physicians predict for healthcare and practice structure in 2015.
1. The majority of respondents, 73 percent, would choose independence if they could be assured of practice profitability and stability. But, nearly half of respondents, 44 percent, expect to sell their practices within the next 10 years.
2. The majority of the physicians surveyed cited downward pressure in reimbursement and rising costs as the most challenging element of maintaining a successful independent practice. These two challenges are the main motivation behind the sale of independent practices.
3. Issues such as reimbursement and regulatory compliance are driving physicians to consider or complete the sale of their practices. Factors that drive the sustainability of independent practice include specialization, stable referral streams, stable reimbursement and efficient cost structure, according to respondents.
4. There are a number of new models of healthcare delivery developing today, from accountable care organizations to intensive medical homes. Nearly all physicians, 94 percent, believe that the marketplace should give rise to new practice models that support physician independence.
5. Of the practice models in existence today, 49 percent of physicians believe that independent practice associations are the most attractive option for maintaining independence. Twenty-eight percent of physician respondents consider practice management/shared-equity models to be the most attractive strategy for maintaining independence, while 23 percent of physicians think mergers and acquisitions in the form of larger practices are the most attractive.
6. Many practices and physicians are undeniably opting for hospital and health system employment in the present, but the survey respondents hold out hope for the future of independence. Seventy-two percent of respondents either "agree" or "somewhat agree" that many physicians currently employed will eventually transition back to independent practice. Only 2 percent of physicians completely disagree with this vision of the future.
7. Nearly half of respondents, 49 percent, expect independent practices to adopt innovative business models to successfully retain independence and coexist with larger health systems. A little more than a third, 35 percent, "somewhat agree" with this idea.
8. While physicians hope to see models of care supporting independence, they are also acutely aware of the factors shaping healthcare delivery, reimbursement and their own chances for viable autonomy. Eighty-eight percent of respondents predict reimbursement will be eventually dependent on clinical outcomes measures that demonstrate quality and value. Seventy-one percent of physicians expect disease management and care of the whole patient to become an important factor in how practices operate.
9. Independent physicians understand the pressures driving their peers towards employment, but the survey's respondents also demonstrate resilience and belief that physician independence is still feasible, especially as changes in healthcare continue to support the development of new models of care focused on quality and value.