Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

More Doctors Giving Up Private Practices
New York Times ^ | March 25, 2010 | Gardiner Harris

Posted on 03/26/2010 10:49:15 AM PDT by reaganaut1

A quiet revolution is transforming how medical care is delivered in this country, and it has very little to do with the sweeping health care legislation that President Obama just signed into law.

But it could have a big impact on that law’s chances for success.

Traditionally, American medicine has been largely a cottage industry. Most doctors cared for patients in small, privately owned clinics — sometimes in rooms adjoining their homes.

But an increasing share of young physicians, burdened by medical school debts and seeking regular hours, are deciding against opening private practices. Instead, they are accepting salaries at hospitals and health systems. And a growing number of older doctors — facing rising costs and fearing they will not be able to recruit junior partners — are selling their practices and moving into salaried jobs, too.

As recently as 2005, more than two-thirds of medical practices were physician-owned — a share that had been relatively constant for many years, the Medical Group Management Association says. But within three years, that share dropped below 50 percent, and analysts say the slide has continued.

For patients, the transformation in medicine is a mixed blessing. Ideally, bigger health care organizations can provide better, more coordinated care. But the intimacy of longstanding doctor-patient relationships may be going the way of the house call.

...

There are political consequences, too. As doctors move from being employers to employees, their politics often take a leftward turn. This helps explain why the American Medical Association — long opposed to health care reforms — gave at least a tepid endorsement to Mr. Obama’s overhaul effort.

Gordon H. Smith, executive vice president of the Maine Medical Association, said that his organization had changed from being like a chamber of commerce to being like a union.

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Culture/Society; Extended News
KEYWORDS: bhohealthcare; doctors; fifth100days; healthcare; hospitals; medicine; physicians
Navigation: use the links below to view more comments.
first 1-5051-68 next last

1 posted on 03/26/2010 10:49:15 AM PDT by reaganaut1
[ Post Reply | Private Reply | View Replies]

To: reaganaut1

It’s unprecedented and unexpected that a 30 yr trend continues?


2 posted on 03/26/2010 10:50:58 AM PDT by Paladin2
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

The doctors in France are unionized....


3 posted on 03/26/2010 10:51:00 AM PDT by griswold3 (You think health care is expensive now? Just wait till it's FREE!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

I need to change my primary care physician and have approached three, no luck yet.


4 posted on 03/26/2010 10:51:55 AM PDT by GregNH (Re-Elect "No Body")
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

Thanks to Hugo Chavez Obama!


5 posted on 03/26/2010 10:52:08 AM PDT by ethics
[ Post Reply | Private Reply | To 1 | View Replies]

To: Paladin2

Obamacare will turn a gentle trend into an upset.


6 posted on 03/26/2010 10:52:15 AM PDT by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
[ Post Reply | Private Reply | To 2 | View Replies]

To: reaganaut1

fyi..NOWHERES in the article are malpractice premiums or frivolous lawsuits mentioned..ya think??


7 posted on 03/26/2010 10:52:50 AM PDT by ken5050 (Save the Earth..It's the only planet with chocolate!!!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

Everything is going according to plan.


8 posted on 03/26/2010 10:54:24 AM PDT by dfwgator
[ Post Reply | Private Reply | To 1 | View Replies]

To: GregNH

What was the reason you were given for non-acceptance?


9 posted on 03/26/2010 10:54:43 AM PDT by verity (Obama Lies)
[ Post Reply | Private Reply | To 4 | View Replies]

To: reaganaut1

This is precisely what the Obama administration wants to happen. They’re going to force doctors to quit (at least the very good ones). Just like their tax policies in the Health Bill will punish companies to the extent they will be forced to lay off people - and the Obama calculus on that is simple. He’s betting laid off employees now needing government assistance to survive will become his and the Democrats salvation in November. he’s betting on the idea the newly turned out masses of the jobless won’t bite the government hand that will be feeding it.

Every company ought to lay out ads saying that if the government took less of their earnings, they’d hire every released employee back.


10 posted on 03/26/2010 10:54:46 AM PDT by antonico
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1
As doctors move from being employers to employees, their politics often take a leftward turn. This helps explain why the American Medical Association — long opposed to health care reforms — gave at least a tepid endorsement to Mr. Obama’s overhaul effort.

Very interesting observation. It's also important to note that as doctors move from being employers to employees, they find themselves dealing with the same economic pressure from foreign labor that destroyed blue-collar jobs in so many industries here in the U.S.

The only difference is that workers in manufacturing jobs lost out when their jobs moved overseas. Workers in health care are losing out when the foreign labor moves right into their own offices and hospitals.

11 posted on 03/26/2010 10:55:43 AM PDT by Alberta's Child ("Let the Eastern bastards freeze in the dark.")
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

The next round of doctors will come out of Obama’s housing projects.


12 posted on 03/26/2010 10:57:00 AM PDT by Sir Gawain
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1
I live in a small town, and was _very_ pleasantly surprised a few weeks ago. We have a small clinic in town. After spending 2 months at Riley Hospital in Indy, we brought my daughter home. We needed to have her doctor in town see her, but she has a halo and was still frail so we hated to take her anywhere by car. Imagine our surprise and pleasure when the doctor called and made plans to see Lydia at our house (he even brought a student with him) to check on her.

It's wonderful knowing that caring, personally caring physicians are still out there. I just hope they can survive what's coming. (I wouldn't be surprised if an underground medical industry grew up on just such a basis, if things continue as they are.)

13 posted on 03/26/2010 10:57:15 AM PDT by Liberty1970 (http://www.caringbridge.org/visit/lydiablievernicht)
[ Post Reply | Private Reply | To 1 | View Replies]

To: ken5050

Frivolous lawsuits, federal and state regulation, price controls on Medicare. Doctors are trained to be doctors, not businessmen, and increasingly, a doctor who runs their own office has to know the Byzantine maze of employer regulations that rule their business lives.

I can see why many of them say “screw it” and just go for the paycheck. Which by the way, isn’t a small paycheck.

Our family doc sold his practice to a big hospital. Office visits went from $56 to $99.


14 posted on 03/26/2010 10:57:32 AM PDT by henkster (A broken government does not merit full faith and credit.)
[ Post Reply | Private Reply | To 7 | View Replies]

To: reaganaut1
As doctors move from being employers to employees, their politics often take a leftward turn. This helps explain why the American Medical Association — long opposed to health care reforms — gave at least a tepid endorsement to Mr. Obama’s overhaul effort. Gordon H. Smith, executive vice president of the Maine Medical Association, said that his organization had changed from being like a chamber of commerce to being like a union.

Nonsense. The AMA endorsed the health care debacle because it no longer represents physicians. It has multiply been posted on FR that AMA represents less than 15% of physicians. Conservative physicians are no longer drawn to the left wingnuts remaining in the AMA.

Physicians for the most part remain very conservative politically and socially. That a state medical association would suggest a statement like this is not surprising since they are tied to the AMA.

15 posted on 03/26/2010 10:58:26 AM PDT by johniegrad
[ Post Reply | Private Reply | To 1 | View Replies]

To: Alberta's Child
It's also important to note that as doctors move from being employers to employees, they find themselves dealing with the same economic pressure from foreign labor

Also, nonsense. Foreign medical graduates are recruited to practices where American candidates can't be recruited or where demand outpaces supply for the American graduates.

16 posted on 03/26/2010 11:00:27 AM PDT by johniegrad
[ Post Reply | Private Reply | To 11 | View Replies]

To: antonico; StarFan; Dutchy; alisasny; BobFromNJ; BUNNY2003; Cacique; Clemenza; Coleus; cyborg; ...
This is precisely what the Obama administration wants to happen. They’re going to force doctors to quit (at least the very good ones). Just like their tax policies in the Health Bill will punish companies to the extent they will be forced to lay off people - and the Obama calculus on that is simple. He’s betting laid off employees now needing government assistance to survive will become his and the Democrats salvation in November. he’s betting on the idea the newly turned out masses of the jobless won’t bite the government hand that will be feeding it.

Every company ought to lay out ads saying that if the government took less of their earnings, they’d hire every released employee back.

Great post, antonico.

The Republicans MUST take back the House and Senate in November. Our only hope right now is that at least they can vote to not fund ObamaCare...

17 posted on 03/26/2010 11:01:48 AM PDT by nutmeg (Bart Stupak: Judas, Neville Chamberlain or Benedict Arnold?)
[ Post Reply | Private Reply | To 10 | View Replies]

To: Sir Gawain

"Kick ass!"

18 posted on 03/26/2010 11:02:05 AM PDT by dfwgator
[ Post Reply | Private Reply | To 12 | View Replies]

To: reaganaut1

Damn! I say, starve the beast. Come next and future elections, close off the spigots and starve the beast. That’s the only hope we have, and stop pussyfooting around leftists. They are thugs, they have acted as thugs; we need a few thugs of our own to go toe to toe with them and shove them back.


19 posted on 03/26/2010 11:02:39 AM PDT by parisa
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

Obama loves this—fewer independent small businessmen, more employees dependent on the government and unions to deal with their employers.

We have to kick every single Social Democrat out of every single office.


20 posted on 03/26/2010 11:03:57 AM PDT by mondonico (Peace through Superior Firepower)
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

...on Monday after Obamacare passed I was in my doctor’s office for my regular 6 month follow-up visit...I asked him if he was going to quit...he said ‘no for now’ but he’s in his early 50s and still has two in college...he was pretty sure that doctors in their 60s would start dropping out however.

.....and then he said something I hadn’t thought about before....sometime in the mid 1990s more doctors came to the US than graduated from US med schools...go to a big city hospital and you’ll see what he’s talking about...third world doctors, some with poor English skills...me, I don’t want to be treated by some guy who went to med school in a foreign country...neither do rich foreigners...that’s why they come here to be treated.


21 posted on 03/26/2010 11:07:04 AM PDT by STONEWALLS
[ Post Reply | Private Reply | To 1 | View Replies]

To: ken5050
fyi..NOWHERES in the article are malpractice premiums or frivolous lawsuits mentioned..ya think??

Or HMO's...Kennedy' plan to destroy the health care business so they could take it over.

22 posted on 03/26/2010 11:08:01 AM PDT by Las Vegas Ron ("Because without America, there is no free world" - Canada Free Press - MSM, where are you?)
[ Post Reply | Private Reply | To 7 | View Replies]

To: johniegrad
Foreign medical graduates are recruited to practices where American candidates can't be recruited or where demand outpaces supply for the American graduates.

Right. And why does the demand outpace the supply?

23 posted on 03/26/2010 11:13:06 AM PDT by Alberta's Child ("Let the Eastern bastards freeze in the dark.")
[ Post Reply | Private Reply | To 16 | View Replies]

To: Sir Gawain

If they have the same mental capacity as Zero then our children won’t be able to find competent doctors for themselves or their children!


24 posted on 03/26/2010 11:13:08 AM PDT by jerri (Is it over yet?)
[ Post Reply | Private Reply | To 12 | View Replies]

To: reaganaut1

The AMA represents a very small fraction of doctors, and I’m sure the leadership has long since been bought off by the progressives to say anything they want. But it is unfair to tar doctors with what the AMA does.


25 posted on 03/26/2010 11:14:29 AM PDT by Mamzelle (Cameras, cameras--never forget to bring your cameras)
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

We will see a sharp rise in labor cartels for health care providers especially physicians. I predict by 2015, we will see the first physican labor cartel. Although I despise labor cartels, I do not think that physicians have a choice. The rats will drop price controls and many other regulations on them. They need to form cartels to fight the tyranny of the rats.

Labor cartels will also spread to many other areas of health care. We will see reduced quality and higher costs as a result of labor cartels in health care. It may be a nightmare to receive treatment in a labor cartel dominated health care system.

I see one potential solution for physicians. Since Indian nations are sovereign, health care providers could set up practices on reservations (with Indian cooperation). This approach has appeal for reservations close to population centers. Physicians may also want to practice offshore on hospital ships. They could spend long periods on ship duty and then return home for extended periods.


26 posted on 03/26/2010 11:19:42 AM PDT by businessprofessor
[ Post Reply | Private Reply | To 1 | View Replies]

To: reaganaut1

Doctors are still 2:1 against socialist medicine. Most doctors who want socialist medicine are losers and have no specialty. They are envy of the doctors with specialties who make more money than them. Envy of other people wealth is the most important driving force in socialism.


27 posted on 03/26/2010 11:20:32 AM PDT by jveritas (God bless our brave troops)
[ Post Reply | Private Reply | To 1 | View Replies]

To: verity

We are not accepting new patients.


28 posted on 03/26/2010 11:23:13 AM PDT by GregNH (Re-Elect "No Body")
[ Post Reply | Private Reply | To 9 | View Replies]

To: ken5050
NOWHERES in the article are malpractice premiums or frivolous lawsuits mentioned.

That's exactly what I thought.

The premium costs are covered by the larger hospitals...but a few years ago a family physician I'm aquainted with was paying over $120k a year for his malpractice insurance. He hung on as long as he could...but he'll be closing the doors and retiring soon. He has a small to moderate clinic which he runs himself.

The insurance company forbid him to do even the most minor surgery in his office a few years back....cutting thousands out of his yearly income. This is all due to frivolous lawsuits.

This healthcare "problem" our legislature is trying to cure.......is one they helped break in the first place. People get millions in settlements (of which the ambulance chasers get the lion's share)....and I guess they believe it's "free" money. Everyone pays in the long run... and here we are.

29 posted on 03/26/2010 11:23:56 AM PDT by LaineyDee (Don't mess with Texas wimmen!)
[ Post Reply | Private Reply | To 7 | View Replies]

To: Sir Gawain

It is called Mehary School of Medicine in Nashville Tennessee. Ask some doctors you know about this school and they can tell the horrors that the school produces.


30 posted on 03/26/2010 11:24:07 AM PDT by jveritas (God bless our brave troops)
[ Post Reply | Private Reply | To 12 | View Replies]

To: Sir Gawain

It is called Mehary School of Medicine in Nashville Tennessee. Ask some doctors you know about this school and they can tell you about the horrors that the school produces.


31 posted on 03/26/2010 11:24:28 AM PDT by jveritas (God bless our brave troops)
[ Post Reply | Private Reply | To 12 | View Replies]

To: STONEWALLS

One pleasant benefit of the new foreign doctors will be their fine ebony masks and pretty feathers on their rattles.


32 posted on 03/26/2010 11:26:14 AM PDT by AEMILIUS PAULUS (It is a shame that when these people give a riot)
[ Post Reply | Private Reply | To 21 | View Replies]

To: GregNH

That is a function of patient load. I encountered the same problem several years ago when my PCP relocated to the West Coast.


33 posted on 03/26/2010 11:27:22 AM PDT by verity (Obama Lies)
[ Post Reply | Private Reply | To 28 | View Replies]

To: johniegrad

and it is the NYT which automatically is suspect.


34 posted on 03/26/2010 11:29:11 AM PDT by rockinqsranch (Dems, Libs, Socialists...Call 'em What you Will, They ALL have Fairies Living In Their Trees.)
[ Post Reply | Private Reply | To 15 | View Replies]

To: griswold3

>The doctors in France are unionized....

Same in Canadastan..


35 posted on 03/26/2010 11:32:10 AM PDT by max americana
[ Post Reply | Private Reply | To 3 | View Replies]

To: johniegrad
"Also, nonsense. Foreign medical graduates are recruited to practices where American candidates can't be recruited or where demand outpaces supply for the American graduates”.

As a home-based medical transcriptionist I can attest that the above statement is true. I work for many foreign-born docs. Interestingly, one in particular is very vocal in his opposition to Obama care.

36 posted on 03/26/2010 11:38:53 AM PDT by bella1 (Four years of Carter gave us eight years of Reagan.)
[ Post Reply | Private Reply | To 16 | View Replies]

To: jveritas

“Doctors are still 2:1 against socialist medicine”.

Not the young ones just coming out of medical school.


37 posted on 03/26/2010 11:41:58 AM PDT by bella1 (Four years of Carter gave us eight years of Reagan.)
[ Post Reply | Private Reply | To 27 | View Replies]

To: AEMILIUS PAULUS

...LOL...good one AEMILIUS PAULUS!


38 posted on 03/26/2010 11:44:56 AM PDT by STONEWALLS
[ Post Reply | Private Reply | To 32 | View Replies]

To: bella1
When they are interns a majority of them make little money and hence are envious of those who make money, therefore they tend to be liberal socialists. But when they start making a lot of money after they get their board of medicine and become full practicing doctors then most of them will be on our side.
39 posted on 03/26/2010 11:50:04 AM PDT by jveritas (God bless our brave troops)
[ Post Reply | Private Reply | To 37 | View Replies]

To: reaganaut1
Do we have a clue as to what it will mean to be in a ‘government approved’ health care plan?

If there are fines, then you must be in a plan. But not just any ol’ plan will work, I assume...

40 posted on 03/26/2010 11:50:27 AM PDT by LearnsFromMistakes (Yes, I am happy to see you. But that IS a gun in my pocket.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Liberty1970

So glad for your experience. Hope your baby is doing well.

You know, I’m not a philosopher and don’t have the best phrasology, but it seems to me that change is a the heartbeat of life. Nothing ever stays as it always was. Now, we’re living a period of rapid change. In the words of Mitt Romney, “It turns out that Barack 0bama goes downhill faster than Lindsay Vonn.” OK, how far down? There are going to be some of us on the trenchlines, there always are. I’m not a visionary or a leader, but I *will* be there to provide logistic and tactical support to those who are. And you will do the same. And eventually, it will get better simply because beyond a certain point, the patriots will not let it get worse.

Bid us and our posterity bow the knee, supplicate the friendship, and plow, and sow, and reap, to glut the avarice of the men who have let loose on us the dogs of war to riot in our blood and hunt us from the face of the earth? If ye love wealth better than liberty, the tranquillity of servitude than the animating contest of freedom—go from us in peace. We ask not your counsels or arms. Crouch down and lick the hands which feed you. May your chains sit lightly upon you, and may posterity forget that ye were our countrymen!

Bid us and our posterity bow the knee, supplicate the friendship, and plow, and sow, and reap, to glut the avarice of the men who have let loose on us the dogs of war to riot in our blood and hunt us from the face of the earth? If ye love wealth better than liberty, the tranquillity of servitude than the animating contest of freedom—go from us in peace. We ask not your counsels or arms. Crouch down and lick the hands which feed you. May your chains sit lightly upon you, and may posterity forget that ye were our countrymen!

http://www.nationalcenter.org/SamuelAdams1776.html


41 posted on 03/26/2010 11:54:18 AM PDT by definitelynotaliberal (My respect and admiration for Cmdr. McCain are inversely proportion to my opinion of Sen. McCain.)
[ Post Reply | Private Reply | To 13 | View Replies]

To: reaganaut1

This is news? Except for the time I spent in Deep East Texas, I haven’t seen a doctor in private practice since I was a teenager. All the large hospitals, Humana, Cedar, Hopkins, Mayo, Baylor, Christus, etc etc, have had doctors on staff not only in the hospitals themselves but in corporate satellite clinics as well.


42 posted on 03/26/2010 11:56:13 AM PDT by Melas
[ Post Reply | Private Reply | To 1 | View Replies]

To: STONEWALLS

A doctor with poor English is exactly what killed my uncle...the doc prescribed two meds that CANNOT be taken together. He didn’t read English well enough to figure that out. This was many years ago in Chicago.


43 posted on 03/26/2010 11:58:17 AM PDT by Spudx7
[ Post Reply | Private Reply | To 21 | View Replies]

Don’t worry, I am sure there is an inexhaustible supply of Bangladeshi doctors.


44 posted on 03/26/2010 12:01:38 PM PDT by NOBO2
[ Post Reply | Private Reply | To 40 | View Replies]

To: Spudx7

...I’ve heard similar horror stories concerning hospital nurses/employees with 3rd world English skills.


45 posted on 03/26/2010 12:09:08 PM PDT by STONEWALLS
[ Post Reply | Private Reply | To 43 | View Replies]

To: bella1

Hi fellow MT. I do acute care a home and I would estimated 50% are ESL (English as a second language), more in California where some of my accounts are.


46 posted on 03/26/2010 12:10:20 PM PDT by gattaca (Great things can be accomplished if you don't care who gets the credit. Ronald Reagan)
[ Post Reply | Private Reply | To 36 | View Replies]

To: jveritas
It is called Mehary School of Medicine in Nashville Tennessee. Ask some doctors you know about this school and they can tell you about the horrors that the school produces.

Maybe its a division of Tennessee State University.
47 posted on 03/26/2010 12:10:36 PM PDT by crosshairs
[ Post Reply | Private Reply | To 31 | View Replies]

To: STONEWALLS

Thanks. However, wonder if the statement is not too far off??? EEEK!


48 posted on 03/26/2010 12:15:01 PM PDT by AEMILIUS PAULUS (It is a shame that when these people give a riot)
[ Post Reply | Private Reply | To 38 | View Replies]

To: Liberty1970

A nice story. I hope your daughter is continuing well on her recovery. Sounds like she’s been through a lot. About 52 years ago, Dr. Reedy came to our house to throw me in the bathtub and run tepid (to me ice-cold) water to bring my skyrocketing fever down. I’ll never forget it; I didn’t want to get in, but she “put” me in. It’s nice to know there are a few doctors like that around today as well!


49 posted on 03/26/2010 12:15:23 PM PDT by mlizzy ("Do not wait for leaders; do it alone, person to person" --Mother Teresa.)
[ Post Reply | Private Reply | To 13 | View Replies]

To: reaganaut1
Of course. What you will see more of is ‘shift’ medicine. When the social contract between physician and patient is broken via the involvement of government, and there is no appreciation of time and commitment, fewer and fewer physicians will be willing to live the lifestyle of a traditional physician. More and more will opt for lifestyle over professional dedication. Ultimately this will lead to a very significant reduction in the quality of care. You can bank on it.
50 posted on 03/26/2010 12:24:15 PM PDT by pieceofthepuzzle
[ Post Reply | Private Reply | To 1 | View Replies]


Navigation: use the links below to view more comments.
first 1-5051-68 next last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson