I continue to hear people predicting the death of small practices. In fact, I’ve met many vendor executives that have essentially started treating small practices as an extinct species. While there are certainly a lot of pressures and challenges associated with running a small practice today, we’re far from the end of small practices.
The biggest challenge to small practices is these major hospital systems that are buying up small practices left and right. We’ve seen this happen all over the country and they’ve become extremely dominant in some parts of the country. No doubt this is a threat to many of the small practices out there and is worth watching.
While many hospital systems are buying up practices, I over heard Dr. Halee Fischer-Wright, President and CEO of MGMA, make a really interesting counter point to this trend. The media and the acquiring hospital systems love to talk about small practices being acquired. However, we don’t give the same coverage to all of the doctors who leave a hospital system or those practices which get divested from a hospital system because they’re not working out as expected.
What does this mean? It means we hear about all of the small practices being acquired, but we don’t really hear about the small practices that leave the hospital system. This means we likely have a false impression of how many small practices actually still exist. I still know of many in my local area and I’m sure you do too. They just don’t get the same coverage as the large systems.
I do think that this current health care environment is harder for small practices than it was previously. The shift to value based care will continue that pressure. However, I heard over and over at MGMA about small practices coming together with vendors to be able to receive the benefits of value based reimbursement while still maintaining their independence.
Certainly this is no longer your father and your grandfather’s healthcare system. However, I still think the small practice is alive and will be for a long time to come.