Independent physicians' consolidation alternative

As supply and labor costs rise and reimbursements decline, many physicians are flocking to employment models for compensation stability. 

Hospital and corporate employment can make it easier for physicians to secure referrals and payer and supply contracts but lack the autonomy many leaders say is central to patient care. 

"Small private practices give physicians the ability to provide the best care for their patients and to adapt to changes quickly and effectively," Joseph Anderson, MD, professor of medicine at Dartmouth Geisel School of Medicine in Hanover, N.H., told Becker's. "Small private practices are the lifeblood of U.S. medicine, and their ability to survive is vital to healthcare in this country."

Specialty-based supergroups could be the solution. The healthcare landscape is not built for independent physicians, and often private practices lack the leverage needed to turn a profit, according to Bertrand Kaper, MD, chairman of orthopedics at HonorHealth Thompson Peak in Scottsdale, Ariz. 

"Attracting the next generation of orthopedic surgeons to private practice is a daunting proposal," Dr. Kaper told Becker's. "The cost of doing business has been steadily increasing, especially in an era where workforce recruitment is extremely difficult and therefore more costly. Offering competitive salaries and benefits to personnel has become the largest cost center in private practice."

Physicians who want to stay in private practice should turn to supergroups, Dr. Kaper said.

These groups are often fully integrated organizations that combine independent physicians and groups into a single practice with a single tax identification number. They provide leverage in accessing economies of scales without completely giving over to a bureaucracy of employment.

Orthopedic and gastroenterology supergroups have exploded in the last few years, with private equity-backed organizations such as Miami-based Gastro Health giving private practices a wider network of physicians, practice locations and ancillary services.

These supergroups offer protection from reimbursement reductions and address patient concerns about the rising cost of care.

Supergroups also can improve patient care. David Bridgers, MD, a gastroenterologist with supergroup One GI and Gastroenterology Associates & Endoscopy Center of North Mississippi in North Oxford, told Becker's that joining One GI has been crucial in improving patient access to resources. 

"We're still relatively a small group, and so we don't we don't have endoscopic ultrasounds. [Being a part of One GI] makes it easy to call one of my colleagues in one of the other groups that are within driving distance from our patients," he said. I get my needs met." 

Megagroup gastroenterologists are also more likely to perform colonoscopies, endoscopies and sigmoidoscopies than gastroenterologists not in those groups, according to a report published by consulting firm Fraser Healthcare and pharma research firm Spherix Global Insights.

They also have less promotional interaction with pharmaceutical companies, especially sales representatives, and are more likely to prescribe biosimilars than gastroenterologists not in a megagroup. 

"I know I can put my head on the pillow at night easier knowing that I have at least some say as to how I operate our practice," Dr. Bridgers said.

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