3.2 - The Businessman

Independent vs Hired - Who brings more Value?

• Robinson JC, Miller K. Total Expenditures per Patient in Hospital-Owned and Physician-Owned Physician Organizations in California. JAMA [Internet]. 2014 Oct 22 [cited 2022 Jan 24];312(16):1663. Available from: https://pubmed.ncbi.nlm.nih.gov/25335148/
Total expenditures per patient in hospital-owned and physician-owned physician organizations in California.pdf
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• Small Primary Care Physician Practices Have Low Rates Of Preventable Hospital Admissions | Health Affairs Journal [Internet]. Health Affairs. 2017 [cited 2022 Jan 24]. Available from: https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.0434
Small Primary Care Physician Practices Have Low Rates Of Preventable Hospital Admissions.pdf
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Who Earns more Money?

Understanding Revenue

Average Revenue Generated by Primary Care Physicians, Specialists, and All Physicians

• 2019 Physician Inpatient/Outpatient Revenue Survey [Internet]. Merritthawkins.com. 2019 [cited 2022 Jan 24]. Available from: https://www.merritthawkins.com/news-and-insights/thought-leadership/survey/2019-physician-inpatient-outpatient-revenue-survey/
2019 Physician Inpatient Outpatient Revenue Survey.pdf
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Independent Physicians are loosing ground

Per Merritt Hawkins Report

• Physician Practice Benchmark Survey [Internet]. American Medical Association. ; 2019 [cited 2022 Jan 24]. Available from: https://www.ama-assn.org/about/research/physician-practice-benchmark-survey
AMA - Physician Practice Benchmark Survey.pdf
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• Popa R. 33 statistics to know about employed vs. independent physicians — Salary, practice setting shift & more [Internet]. Beckersasc.com. 2020 [cited 2022 Jan 24]. Available from: https://www.beckersasc.com/benchmarking/33-statistics-to-know-about-employed-vs-independent-physicians-salary-practice-setting-shift-more.html ‌

The Business of Health Care Depends on Exploiting Doctors and Nurses

Opinion | The Business of Health Care Depends on Exploiting Doctors and Nurses (Published 2019)

In a factory, if 30 percent more items were suddenly dropped onto an assembly line, the process would grind to a halt. Imagine a plumber or a lawyer doing 30 percent more work without billing for it. But in health care there is a wondrous elasticity - you can keep adding work and magically it all somehow gets done.

https://www.nytimes.com/2019/06/08/opinion/sunday/hospitals-doctors-nurses-burnout.html

Challenges in Private Practice

• Contracting - Contracting with Insurers

• Administrative Tasks - Lead to burnout

• HealthIT - EHR Death by a thousand clicks & Cybersecurity

Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

The U.S. government claimed that turning American medical charts into electronic records would make health care better, safer and cheaper. Ten years and $36 billion later, the system is an unholy mess. Inside a digital revolution that took a bad turn.

https://khn.org/news/death-by-a-thousand-clicks/

You are responsible for complete Care delivery workflow

White Paper - State of the Independent Practice Industry Report

The independent medical practice is the cornerstone of the United States healthcare system, providing a higher volume of care at a lower cost and resulting in better outcomes for patients, as compared to hospitals or larger medical groups. However, in recent years, independent practices have faced difficult challenges due to rapidly changing regulations, payment models and patient expectations.

https://www.kareo.com/resource/wp_10301/white-paper-state-independent-practice-industry-report

Factors to consider

• Who is Happier?

• Both

• Career satisfaction rate

• 72 percent for employed physicians

• 73 percent for self-employed physicians

Employed vs Self-employed Physicians: Who's Happier? These Are the Tradeoffs

Is the grass really greener, or does it just appear that way? For many physicians, it depends which values are most important to you. Regular hours vs lack of autonomy? Productivity goals vs more night call? Medscape examined the key issues affecting employed physicians, looked at the major differences in satisfaction between employed and self-employed physicians, and came up with some intriguing findings.

https://www.medscape.com/viewarticle/863852_print

Should I choose to be an Independent Physician or Employed?

• Depends on your personality

• Do you enjoy management task/ have skills?

• Do you prefer to be your own boss?

• Is your choice of Specialty highly dependent on being in a health system?

• Is your Location highly dependent on being in a health system?

• Is your choice of Specialty highly dependent on care team and multidisciplinary care?