Finances driving physicians out of solo practice

The business of medicine has doctors moving into large groups or employed situations, studies find.

By Bob Cook, AMNews staff. Sept. 10, 2007.

The "herding cats" metaphor long used to describe the difficulty of organizing physicians into large groups appears to be on its way out.

A survey released in August by the Center for Studying Health System Change found a marked increase in the percentage of doctors joining large, single-specialty groups, as well as entering employed situations. The survey, covering 1996 to 2005, also found a marked decrease in the percentage of physicians in solo or two-doctor practices, as well as a large drop in the percentage of doctors who have an ownership stake in their practices. The finding was especially apparent among older physicians.

The CSHSC did not ask physicians why they worked where they did. But the center and other observers say financial pressures and the desire for work-life balance is driving physicians to the relative security of an employed or large-group situation. That way, they can keep semi-regular hours, have less responsibility for the business side of medicine, and possibly gain greater leverage in contract talks with health plans.

Observers say this trend is not going away anytime soon and might well reflect a growing cultural change among physicians.