According to a survey by the American Medical Association (AMA), in the fall of 2020, 49.1 percent of physicians worked in private practices instead of being employed in hospitals. This is the first time since the surveys began in 2012 that doctors in private practice fell below 50 percent. Among them, 17.2 percent worked in private practices that had 50 or more doctors. These are usually known as multi-specialty group practices. They are not hospitals, though.
The decrease in the number of doctors in private practice is a disheartening development. According to a study in the Annals of Family Medicine, patients who go to doctors employed by hospitals are more likely to avail of that hospital’s services even if these are more expensive and of lower quality.
On the other hand, physicians who have a private practice maintain a more personalized doctor-patient relationship that includes the full trust of the patient and higher responsiveness from the doctor. This results in fewer preventable hospital admissions and readmissions and lower costs for the patient.
Advantages of Private Medical Practice for Physicians
The primary advantage of having a private practice is the physician’s autonomy. A doctor or a small group of doctors co-owning a practice have the flexibility and agility to make decisions without going through corporate red tape. They can quickly implement their decisions on new health services or new ways of doing things that will immediately benefit their patients.
Also, due to this autonomy, the physician or physicians in the small private practice can create their own work culture. They can determine their work hours, strike a work-life balance, and prevent burnout. The AMA cites research stating that physicians in private practice have fewer experiences of burnout compared to those employed in hospitals. Their autonomy, flexibility, and more personal relationships with patients are all cited as factors in lowering the risk of burnout.
Burdens of Private Medical Practice
Doctors in private practice must deal with administrative burdens, though. These cause stress and take time away from their primary role to care for their patients. Among these tasks are coding and billing, bookkeeping, accounting, payroll, managing human resources, procurement of equipment and supplies, managing the facility, and marketing. There is also the need to be on top of regulatory compliance.
Another issue is revenue. During the pandemic, most people stayed away from doctors’ offices. To avoid exposure to Covid 19, they postponed check-ups that were not for medical emergencies. This significantly lowered the income of physicians in private practice. A survey by the Larry A. Green Center and Primary Care Collaborative in August 2021 showed that among private primary health care practices, 10 percent were unsure of their financial standing for September, two percent were thinking about filing for bankruptcy, and two percent had already closed.
Developments and Solutions
The administrative burden on physicians in private practice can be addressed by the proper outsourcing of services. Doctors can outsource bookkeeping services and choose a service provider that offers other services like billing, insurance verification, assistance on insurance claims, appointment scheduling and confirmation, and phone answering around the clock.
Working with fewer service providers simplifies matters. Some companies provide full accounting services, including payroll. It is also crucial to hire an administrative manager to oversee all these outsourced services and other tasks such as procurement and facility management, among others. This will free the doctor to focus on patient care.
Doctors must recognize that digital marketing is the most effective way to reach any target market today. Physicians in private practice must hire a website building and management service that also does digital marketing. A professional-looking website is essential. It must provide a means for a patient to contact the clinic’s human answering service at all hours. The service agent must then contact the doctor if the call is an emergency.
This connects with the need to provide telehealth services. Telehealth has become the norm during the pandemic and solves the issue of patients not wanting to go to doctors’ clinics. The AMA has a webinar called “Clinical Case Study: Telehealth for Primary Care.”
For further support, doctors who are members of the AMA can apply for membership in the AMA Private Practice Physicians Section (AMA-PPPS), launched virtually in April 2021. They must work in a private practice owned and controlled by physicians and with not more than 50 physicians. The AMA-PPPS is a forum where these doctors can connect, discuss their ideas, share new and best practices, and create policy proposals reflecting their sector’s needs and interests.
Continuing the Tradition of Private Clinics
There is room for the establishment of more physician private practices and room to grow for all. This has been known to be a better setup for doctors’ well-being and is emotionally rewarding. It can also be financially rewarding with the right tools. It is definitely a better option for patients.
