Panelists outline decline of small doc practices

In Capitol Hill testimony, the head of physician-recruitment firm Merritt Hawkins said that about 75% of his firm’s physician placements will be as hospital employees in two years if current trends continue. At a hearing of the House Small Business Committee’s Subcommittee on Investigations, Oversight and Regulations, a panel of experts explained to lawmakers how—and why—small and solo U.S. medical practices have declined in recent years. Mark Smith, president of Merritt Hawkins, said that between April 2011 and March 2012, 63% of the company’s physician-search assignments featured hospital employment of the physician, compared with 56% from the year before and 11% in 2004. He cited flat or declining reimbursement, growing regulatory and administrative hassles, malpractice-insurance costs, health information technology implementation and the effects of healthcare reform as the reasons why. He added that the small, private-practice model is likely to persist in smaller, rural areas where there are few physicians, but even those doctors will likely partner with larger groups. Meanwhile, the American College of Cardiology estimates that between 60% and 70% of its current physician members have integrated with hospitals, Dr. Jerry Kennett, a Columbia, Mo., cardiologist and chairman of the ACC’s Advocacy Steering Committee, told the panel. Dr. Joseph Yasso, a family physician who testified on behalf of the American Osteopathic Association, said the trend can compromise the patient-physician relationship because employed doctors work for “X number of dollars and X hours a week.”