Doctors Dump Small Practices To Join Large Providers

Intimidated, in part, by the health IT expenses they’re expected to bear, doctors are leaving private practices to seek jobs with large healthcare organizations, according to a new study by Accenture.  The need to purchase EMRs certainly isn’t the only reason doctors are jumping ship, but it is one of the most important reasons, the firm found.

Accenture interviewed 204 doctors in May, drawing from an even mix of primary care docs and specialists across equally-divided sections of the U.S.

The study results projected that only 36 percent of doctors will remain part of an independent practice by 2013, down from 39 percent this year and 57 percent in 2000. (I knew doctors were streaming into integrated health systems but that blew my mind.)

According to the Accenture survey, 53 percent of doctors responding said that EMRs requirements drove them to look for employment with big health organizations.

Doctors are also spending big on updated practice management, billing and scheduling applications. My guess is that in some cases mobile health spending is beginning to rear its head as well, even in smaller practices. After all, while doctors generally bring their own devices to the party, practices may see it as in their interest to own mobile gear and applications as they become more central to care delivery.

On the other hand, health IT may also be the saving grace for some. Doctors who do remain independent are likely to offer telemedicine or online consultations to help keep their profits at an acceptable level, researchers found.

Readers, I doubt any of you are too surprised by Accenture’s findings. I doubt public policy planners are either.

Given these realities, I’ve always wondered why no one has proposed re-structuring Meaningful Use for smaller organizations to account for the disproportionate effect such investments have on the smallest practices, say those with five doctors or less.  Incentives are all well and good, but if we don’t want to see independent practice all but wiped out, perhaps some up-front grants are in order.