AAOS Concerned About Decline in Private Practices

By Jaimie Oh | July 23, 2012

American Association of Orthopaedic Surgeons Fellow, Louis McIntyre, MD, recently testified before the House Small Business Subcommittee on Investigations, Oversight and Regulations on the cause and impact of the decline in private practices.  

During the hearing, Dr. McIntyre explained how increasing administrative and regulatory burdens from the American Recovery and Reinvestment Act and the healthcare reform law, coupled with decreasing reimbursements, has forced his New York-based private practice to join a hospital group.  

According to the AAOS, Medicare reimbursements for common orthopedic procedures, such as torn meniscus surgery, have decreased up to 28 percent in the last decade, and reimbursements from private insurers have fallen in a similar fashion. At the same time, practice costs, especially medical liability insurance costs, have risen exponentially. Dr. McIntyre told the subcommittee that his medical liability insurance rates have risen by 300 percent from 1994 to 2010. According to AAOS, this has resulted in a 300 percent increase in hospital employment of orthopedic surgeons between 2004 and 2010.  

Dr. McIntyre fears that growing physician-hospital employment could lead to a shortage of employed positions that would threaten healthcare access, decreased physician autonomy, barriers to innovation and more.

"There is, and will continue to be, an increased need for physicians with the implementation of PPACA," Dr. McIntyre said. "If private practice disappears, patient access to care, local employment and tax revenue will all suffer. We need to strengthen private practice as well as the other models of healthcare delivery to ensure patient access to quality care."