Are Practice Acquisitions A Threat To Physician Autonomy?

Physicians are wary of the term “corporate practice of medicine.” It implies a practice environment in which corporations directly influence and control the doctor-patient relationship. In other words, when corporations “practice medicine,” physicians risk losing one of their profession’s most cherished values — physician autonomy — a doctor’s commitment to providing physician-directed patient care without outside intervention.

Dr. Ken Teufel is the Medical Director at Interim Physicians.

Preserving physician autonomy is becoming more of a challenge as an increasing number of independent practices are acquired by hospitals and other corporate entities. Nearly half of all physician practices in the U.S. are now owned by hospitals or non-hospital corporations, according to a recent study by Avalere Health.

The study showed a marked increase in corporate acquisitions of physician-owned practices from 2019 to 2021. Private equity firms and other corporations acquired 17,700 independent practices during this two-year period, a 32% increase in practices that are corporate-owned. Practices nationwide were equally affected by the buyout trend.

The pandemic was a major reason for the dramatic increase. “Covid-19 exacerbated financial vulnerabilities of physician practices and forced them to make difficult decisions,” said Kelly Kenney, chief executive officer of the Physicians Advocacy Institute (PAI).

PAI points out that “physicians should be in the driver’s seat when it comes to managing their patients’ medical care. Regardless of the practice setting, physicians must retain autonomy to make clinical decisions, free from interference by corporate entities motivated primarily by profits,” said Kenney.

Another recent study links mergers and acquisitions to widespread physician burnout, especially among female physicians and physicians under 65. Researchers at athenahealth found that “Physicians who experienced mergers and acquisitions reported feeling less positive about their collaboration with colleagues, less safe and supported, and less inspired to go above and beyond in their work.”

“This makes it even more notable that on balance, physicians continue to be committed to delivering superior patient care.” To this end, preserving physician autonomy must be made a priority.

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