In the U.S., about 12,500 clinical gastroenterologists are in private practice, multispecialty groups and hospital-based settings.
Nearly 6,000 of those GIs are in private practice. In recent years, experts have painted independent practices as a dying breed, due to hospital acquisitions and site-of-service payment differentials favoring hospitals. But Fred Rosenberg, MD, of Elgin-based Illinois Gastroenterology Group, penned a column in The New Gastroenterologist explaining the intricacies of private practice and why hospital-based threats may soon be a thing of the past.
Here are five takeaways:
1. Hospitals and private practices have unique pros and cons. Hospitals are typically reimbursed at higher rates than private practices, but in the 2019 Medicare Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule, CMS is shrinking the differential. The move will bring reimbursement rates closer in an attempt to drive traffic to less expensive services, which are often offered by private practices.
2. Private practices will also benefit from an aging population and an aging GI physician workforce. As more patients demand GI services and GI providers retire, demand for GI physicians will skyrocket.
3. Dr. Rosenberg entered private practice in 1978 and continues advocating for it. He said private practice allows physicians to develop "family-type" relationships with patients, and gives young gastroenterologists leadership roles earlier in their career.
4. Some view private gastroenterology practices' small size as a disadvantage. Although some practices still tout low physician numbers, single-specialty practices are more often consolidating to become GI group practices. Many urban areas have 10 or more physicians in their practice, and some GI practices exceed 100 physicians.
However, the growth is not without consequences. Whereas a newer physician can more easily take on leadership roles in a smaller practice, that same physician could feel detached from decision-making processes in a larger private practice.
5. Dr. Rosenberg said, "There are many things to consider when choosing a career path. Independent practice in gastroenterology continues as a vitally important component of care delivery, and it's my hope that the new generation of gastroenterologists finds their journey as rewarding and personally satisfying as mine has been."
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