Physicians are losing autonomy as the workforce flocks to employed models.
Around 56% of employed physicians said what they like least about their job is less autonomy, according to the Medscape's "Employed Physicians Report 2023," a jump from 48% the previous year.
Vladimir Sinkov, MD, founder and CEO of Las Vegas-based Sinkov Spine Center, joined Becker's to discuss how these declines in autonomy will transform healthcare.
Question: Can you characterize the long-term ramifications of the decline in physician autonomy?
Editor's note: This response was edited lightly for clarity and length.
Dr. Vladimir Sinkov: We're already seeing the effects. Physician autonomy has declined significantly since the advent of Medicare in the 1960s.
When physicians become employees, they are often asked to see more patients, which reduces the quality of care. No matter how skilled a physician is, seeing more patients per day inevitably lowers the quality of care. Access to care also decreases if physicians are owned by entities that limit who can see them. Overall, healthcare costs go up because the entities that own physicians focus on maximizing profits. This applies to both for-profit and nonprofit hospitals and insurance companies.
Efforts to improve access and lower costs, like value-based care, have not effectively controlled healthcare costs. Unless we do something different, the quality and access to care will continue to decline, and costs will rise.