Independence versus employment is something that weighs on physicians across the country as reimbursement rates decline, operational costs soar and corporations continue to make sweeping buyouts.
Increased leverage with payers and job security in a touchy private practice market are among the silver linings for some physicians in employed settings –– but many remain unsatisfied.
"I think consolidation has not really produced the results that were promised by the consolidation," Matt Mazurek, MD, assistant clinical professor of anesthesiology at St. Raphael's Campus of Yale New Haven (Conn.) Hospital told Becker's.
Dr. Mazurek said that consolidation has disappointed physicians on a number of fronts.
"First of all, access has not improved. It's gotten worse. Second of all, costs have not reduced — it's actually increased across the board," he said. "I don't see consolidation producing all of the promises that were made when it was pitched with some health systems having approached the leaders in a particular community promising access to various resources."
These 'unfulfilled promises' include assurances made to physicians and practice-owners when a private practice is acquired by larger players.
"So when these systems come in and say that they'll … save the practice, some are even hostile takeovers," Dr. Mazurek said. "They say nothing's going to change for the first couple of years, and while that may be true, eventually the system will want to adopt what works in their best interest, not necessarily the physicians' best interest, and the resources begin getting taken away."
These unfulfilled promises are due in part to the for-profit nature of these buyouts, Dr. Mazurek said, but this often applies to non-profit groups buying up healthcare organizations.
"You would think the nonprofits would be behaving in a different manner just because their mission statements are different, but I think what we have discovered across the board is nonprofits are behaving in a similar manner," he said. "They're just tax exempt. So the way I look at it is that every player's the same, they just have different labels."