The number of hospital-employed physicians continues to rise, but the trend may be slowing as significant numbers of employed doctors are switching to independent practices. Many physicians are either launching their own practices or joining with other independent providers in a move away from employed positions. Although employment offers security and stability, independence provides autonomy, flexibility, and an opportunity to offer more affordable care to patients.
The number of hospital-owned physician practices has increased in recent years, but the numbers are still low in the southern and western geographic regions of the US. According to a Physicians Advocacy Institute/Avalere analysis, 28% of physician practices were owned by hospitals in the South and West as of January 2018. In the southeast, especially in North Carolina and Georgia, the healthcare environment is heavily focused on fee-for-service models, which makes it more conducive to the success of independent practices.
Between September 2018 and March 2019, two separate groups of physicians based in North Carolina and employed by large health systems, Atrium Health and Novant Health, left their employers to form or join independent practices. Ninety physicians resigned their employment with Atrium Health and another 42 left Novant.
Dr. Dale Owen, formerly employed by Atrium Health, left that system along with a number of other providers to form Tryon Medical Partners in Charlotte, for which Dr. Owen is now CEO. Dr. Owen states that the high level of fee-for-service medicine “could be one reason the Charlotte region has seen an exodus of hospital-employed doctors as they step out onto a stable platform where an independent group can launch a practice without taking on additional risk.” Charlotte, North Carolina, is actually one of the highest-cost places in the country in regard to receiving healthcare.
Owen adds that “The epicenter of change you are going to see from an independent physician standpoint is Charlotte. Fee-for-service allows groups to solidify themselves and pave the way for others to come out. You can start up a practice while standing on fee-for-service and morph rapidly into value-based medicine.”
Dr. Ehab Sharawy, who left Novant to join Holston Medical Group, says that being independent doesn’t necessarily mean being anti-hospital. Rather, independent practices are able to be more patient-centric, as they are not tied up in corporate regulations or decision-making processes. Providers in independent practices also experience lower burnout rates, attributable to their autonomy and flexibility in providing quality care for their patients.