Why this physician believes 'private practice is under attack'

When looking toward the future of private practice, not all are optimistic. 

Ismar Dizdarevic, MD, an orthopedic surgeon at Ridgewood (N.J.) Orthopedic Group, connected with Becker's to discuss what private practice may look like 10 years from now.

Note: This response has been lightly edited for length and clarity.

Dr. Ismar Dizdarevic: Private practice is under attack from various fronts and will eventually succumb to defeat. It will impact access to quality healthcare as we perceive it today not just in the private practice realm but all models of healthcare as it will diminish the leverage physicians have in any negotiations.  

Insurers will have lowered reimbursements to the level of non-sustainability under the guise of "value" while demanding more resources from the practices in terms of prior authorizations, documentation and denials. Private practice physicians will be left with a decision to either stop accepting lower reimbursing payers, namely Medicare; become employed themselves; join larger single specialty or multispecialty groups; or subscribe to the growing although limited field of cash/concierge medicine. 

The private practice that remains after the fallout will be composed of large regional single specialty or multispecialty groups, which unfortunately will not behave like the community-based private practice of yesteryear but rather more akin to large corporations subscribing to the same cost-cutting tactics used by larger hospital systems today. Physicians will no longer accept new patients as incentives to do so will dwindle, further worsening the shortage and access to care primarily for fixed-income seniors. Access to concierge/cash medicine will increase for those with available resources, and small isolated pockets of true private practice will remain in wealthy areas able to demand personalized care. Unfortunately, most small community-based practices will close their doors permanently.

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