Private practices continue to operate in an environment full of consolidation and economic uncertainty, but how will these conditions and more alter their future?
Five healthcare leaders connected with Becker's to discuss what private practice may look like in 10 years.
Note: Responses have been lightly edited for length and clarity.
Braden Batkoff, MD. Chief Medical Officer of United Cardiology Partners: Given the growth of procedures moving to the ambulatory space, I predict the emergence of new hybrid employment models different from pure private practice or current hospital employment. I see physicians wanting to preserve a sense of autonomy and have the ability to diversify their revenue by participating in ambulatory economics while maintaining alignment with health systems.
Bhagwan Satiani, MD. Professor of Surgery Emeritus in the Department of Surgery at the Ohio State University (Columbus): Private practice will still be around, just different. Suspect practices left standing will be: large single-specialty or multispecialty groups or those owned by large national systems such as United Healthcare, Cigna, etc., or private equity. I guess you could call them private. Bottom line, there will be fewer "self-employed."
Li Sun, DO. Orthopedic and Spine Surgeon at Sun Orthopaedic & Spine Care (Metuchen, N.J.): I think private practice will have drastic changes within the next five to 10 years. With recent reimbursement changes from major medical insurances as well as cuts from CMS, it is very difficult to maintain revenue in private practice. I think fewer and fewer private practices will be able to survive on their own without being affiliated with healthcare systems or large [management service organizations]. As regulation continues to evolve, I think more and more procedures will be moved to ASCs. Unfortunately, I think many practitioners will have to increase surgical volume in order to maintain the same lifestyle.
Sheldon Taub, MD. Gastroenterologist at Jupiter (Fla.) Medical Center: I am very discouraged about what private practice will look like in 10 years, if it still exists. Between hospital systems and big business buying up practices, the private practitioner may become the lone ranger. The role for the concierge practitioner may continue to exist, but that will be only in selected areas that can afford it. The healthcare system will have to change, and that will depend upon the government to get more involved. I anticipate the motivation to go into medicine will continue to decline. The outlook for healthcare in this country is in question.
Gregg Wolff, MD. Orthopedic Surgeon at Wolff Orthopedics (Cumberland, Md.): I see the future in ambulatory centers. The outpatient total joint has become the model for the future. Unfortunately, this will continue to squeeze reimbursement to the point where even total joint surgery compensation for professional services will be so small that the only way it will become time efficient to do the cases will be if a physician has an equity involvement with the ASC or is employed by big brother. Moreover, the hospital lobby will continue to cry foul and push back on the trend, citing lost revenue. As with all models, saving money by continuing to cut reimbursement to the surgeons will prove false yet again because big brother can't cut costs effectively.