Health Care Politics Management

Physicians Fleeing Private Practice for Hospitals

doclapOn the surface, doctors taking on salaried jobs at hospitals might seem like good news for health care costs. One driver of health care inflation is the “fee for service” model, which gives doctors an incentive to deliver the maximum feasible number of billable services per patient. Salaried positions, on the other hand, are supposed to keep down costs, because you get paid the same no matter how many tests you order.

But it’s not that simple,

via Your Hospital Bill Is About to Get a Lot More Expensive – The American Interest.

Dentistry is quickly becoming the last bastion of the independent professional. Other traditional “professionals” like lawyers, architects and pharmacists have long ago gone from independent small business owners to employees of big business. Physicians have been coagulating into bigger and bigger groups for years and with current economic and political conditions independent private practice is disappearing quickly.

Some of this can be blamed on record keeping requirements. The more complex records and payment systems become the higher the cost of compliance. At some point independent single practice is no longer financially viable. The linked article goes on to explain that hospital based physicians are likely to drive up costs rather than reduce them, but that is another story.

In theory digital record keeping and communication should reduce these compliance costs. That has certainly been the case in other industries like banking and publishing. However ham fisted “meaningful use” rules and requirements have turned EMR (Electronic Medical Records) into a frustrating, expensive politically driven boondoggle.

So far digital dental records like Dentrix have been flying under the meaningful use radar and have avoided the bureaucratic morass that has doomed medical systems. Dentists can in fact reduce overhead and compliance costs considerably with electronic records.

There is no question that, like medicine, independent solo practice in dentistry is eroding. Large corporate groups and DMSOs have a far larger percentage of the profession now than in the past. Never the less the vast majority of dentists are still independent small business people.

In my opinion one of the primary reasons people choose to become dentists is the promise of independence. People who choose to enroll in dental school are intelligent, talented and ambitious. They could succeed in almost any professional career. One of the reasons they choose dentistry is because it offers the best chance to be your own boss.

Related from NYT:

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