We’ve seen a dramatic shift in healthcare over the past 3-5 years. More and more small group and independent practices have been selling to much larger health systems. Plus, we’ve seen a consolidation of health systems as well. The move to larger and larger health organizations has happened and I’ve heard many predict that we’ll never go back.
While I know there are pressures that indicate this might be the case, I also wonder if the independent doctors and small group practices that remain are the real industry disruptors. Are they the tough ones that survived through the challenging healthcare environment?
With this thought in mind, I looked up the definition of “survival of the fittest”:
the continued existence of organisms that are best adapted to their environment, with the extinction of others, as a concept in the Darwinian theory of evolution.
Sounds a bit like the independent practice to me. Those independent practices that still exist have had to adapt to the changing healthcare world. The ones that remain are likely the most “fit”. We’ve also seen a lot of other independent practices go “extinct.”
Does this give us hope? On the one hand, I can see how those independent practices that remain are strong and can adapt well. I hope that they do it so well that they disrupt the whole healthcare system in a good way. I think that the health system is generally better with more independent practices. There are a certain ownership and patient kinship that happens with independent practices that is often missing in larger health systems that treat doctors like machines that need to produce certain numbers. It’s unfortunate for healthcare that this is being lost.
The thing that scares me most about this trend is that most of the independent doctors seem to be older doctors. Most of the younger doctors I know are just fine going to the large health systems. They don’t want to take on the risk of starting their own practice. If the younger generation isn’t willing to fight the independent practice fight, then independent practices will die.
How many doctors at large health systems have created real disruptive innovation? Not very many. That’s a scary thought that should all have us worried about the future of the independent doctor. Once it’s gone. It will be hard to see how it could come back.
If you don’t think this is a big deal. Think back to the last time you called your cable provider. There’s a reason they’re ranked the lowest in customer service. They have very little competition to force their hand. The loss of independent practices will mean very little competition for the big healthcare organizations. That’s a bad thing for all of us.
What do you think about independent practices? Are the ones that remain the strong ones? Will the independent practices survive in healthcare? I look forward to reading your thoughts on social media and in the comments.