Where Have All The Doctors Gone?

Many individuals in search of a primary care doctors have found, much to their dismay, find that independent practices have gone way in favor of the likes of Sony Walkman and Cabbage Patch Kids.

Independent medical practices are an important component of the medical system. They provide communities with access to care and help reduce long wait times. So why is it getting harder and harder to find reliable independent medical practices? The unfortunate reality is that they’re too expensive.

Startup Out Expenses

Young doctors face formidable start-up costs. There’s an office to furnish with up-to-date diagnostic equipment like EKG machines, blood pressure monitors, medical instruments, examining tables, lab chemicals, and more. But that’s just for general practitioners. Specialists face the cost of delicate tools specific to their trade. And don’t forget staff salaries and insurance costs. It’s amazing that even a few young graduates attempt opening up a medical practice on their own, considering these high costs.

Many will choose to purchase the practice of a doctor who is retiring. But depending on the age of the equipment and the location and size of the practice, taking over an existing practice can be almost as challenging as starting one anew.

Ongoing Expenses

Although doctors may make a decent living, expenses like staff salaries don’t remain stationary – they go up over time. If a doctor is happy with their staff and wants to keep their nurses, assistants, and front office personnel, they will need to offer salary increases on a consistent basis. Costs of health insurance and other benefits go up year after year. And just like in your office, computers and other equipment soon grows obsolete, so there are upgrade costs as well.

The Sharing Solution

Many physicians who have been in practice for a while have discovered they can lower their overall costs by sharing office suites with other doctors, those in the same field, as well as those who have other specialties. By doing so they share common costs such as rent, custodial expenses, and front office staff salaries.

Eight Years of Shrinking Numbers

The American Medical Association has been aware of the growing shift away from private practices to multiple physician-owned practices thanks to the AMA analysis of practice arrangement, which has been conducted every two years since 2012. What they found in the latest survey confirmed that the downward trajectory had sped up. Of the 3,500 physicians participating, 54% had been independent practices. By 2020, that number had shrunk to 49.1%, the steepest downhill trajectory in the eight years the survey had been in existence.

The Growth of Large Hospital Systems

An organization known as PAI, which is short for Physicians Advocacy Institute found that as private practices were shrinking the number of doctors opting to work with hospital systems was growing. Like the AMA, they have been carrying out biannual surveys since 2012. And what they found in the 2018 PAI analysis was those hospital systems had acquired more than 8,000 medical practices since 2016. And the number of physicians who had given up previously taking the independent route increased by a shocking 7,000.

An Alternate Solution

Many doctors who prefer to embark on their medical careers alone or band together into small neighborhood specialty practices, attribute their independence to medical practice loans. Whether they secure a term loan or a line of credit they can find a preferable and manageable way to maintain their own distinctive and pave their own career.

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