Demise of Small Group and Solo Physician Practices Bodes Ill for Physician-Patient Relationship, Panel Told

By Steve Teske

Will small group and solo physician practices still be around in another decade?  The trend is toward increasing numbers of doctors abandoning small practices to align themselves with hospitals or other health care entities, representatives from several physician organizations told the House Small Business Committee July 19. The health care reform law, with its emphasis on Accountable Care Organizations, likely will accelerate that trend, the committee was told.  

   This trend may not bode well for the physician-patient relationship. Louis McIntyre, an orthopedist who works for White Plains Hospital in New York, told the committee that working for a larger entity rather than in a small group practice “significantly decreases physician autonomy” and will put health care decisions in the hands of administrators and not practitioners.

   “Physicians are in the position to interact with patients on a daily basis and identify deficiencies in patient care,” McIntyre said. “Administrators are more removed and may not appreciate patient care issues that arise in the ambulatory setting.” McIntyre also said hospitals “are more risk adverse, and are less willing to examine new and untested practice projects.”

   “If private practice disappears, patient access to care, local employment and tax revenue will all suffer,” McIntrye said.