Dermatology: The Last Refuge for Private Practice?
The unprecedented challenges that I have been discussing in this column over the last several months—the Patient Protection and Affordable Care Act, drastic revisions in confidentiality rules and diagnosis codes, and the movement toward electronic health records, among others—have triggered widespread predictions that the independent private physician practice model will largely be replaced in the not too distant future. Private practice physicians need a strategy tailored to the current situation and long-term goals.
Practice Points
- Private practices that can adapt to changes brought on by health care reform will survive and even flourish. Private practice physicians must weigh their options to find a strategy that is tailored to their current situation and long-term goals.
- Cooperative groups allow small practice physicians to pool resources while maintaining independence as a private practice.
- The number of independent practice associations has grown, but there are risks.
- Accountable care organizations allow a network of physicians and hospitals to share financial and medical responsibility for providing coordinated and efficient care to patients.
Final Thoughts
Clearly the price of remaining autonomous will not be insignificant, and many private practitioners will be unwilling to pay it. Only 36% of physicians remained in independent practice at the end of 2013, a decrease from 57% in 2000.2 Does that mean that private practice is doomed, as the “experts” predict? Absolutely not. Those of us who remain committed to it will find a new strategy. As always, we will adjust and adapt as the playing field changes. In medicine, as in life, those who are the most responsive to change will survive and flourish.
