What five physicians think about private practice's future

Here's what five physicians shared about the future of private practice with Becker's in May.

Editor's note: This response was edited lightly for brevity and clarity. 

Bhagwan Satiani, MD. Professor of Surgery Emeritus in the Department of Surgery at the Ohio State University (Columbus): Private practice will still be around, just different. Suspect practices left standing will be: large single-specialty or multispecialty groups or those owned by large national systems such as United Healthcare, Cigna, etc., or private equity. I guess you could call them private. Bottom line, there will be fewer "self-employed."

Lali Sekhon, MD. Surgeon at Reno (Nev.) Orthopedic Center: Private practice physicians are small business people as well actually providing healthcare. Private practice is like running a corner store. Simple economics suggests decreased salary or increased expenses reduce take-home pay. In no particular order:

1. Reduce physician payments. Over the past few years, reimbursement has tanked. 

2. Inflation increases physician expenses.

3. Poor payer mix. We all lose money on Medicaid and do it as a sense of community, responsibility and service. Medicare is headed the same way.

It amazes me when I do a major lumbar instrumented case in the operating room knowing the hospital, the neuromonitoring company and the implant company and representatives are getting paid better than I am, but I'm finding the surgery and taking all the risk. Time will tell where this all heads. You get what you pay for.

Matt Mazurek, MD. Assistant Clinical Professor of Anesthesiology and Director of Quality and Safety at St. Raphael's Campus of Yale New Haven (Conn.) Hospital: Physician service reimbursement has declined year over year for decades, and inflation-adjusted compensation has drastically been reduced. Around 140,000 physicians quit or retired over the past three years, and many physicians are looking for a way out of the healthcare system. Part of the problem is consistent downward pressure on reimbursement. Private practices can no longer afford to stay in business.

Ismar Dizdarevic, MD. Orthopedic surgeon at Ridgewood (N.J.) Orthopedic Group: Private practice is under attack from various fronts and will eventually succumb to defeat. It will impact access to quality healthcare as we perceive it today, not just in the private practice realm but all models of healthcare, as it will diminish the leverage physicians have in any negotiations.  

Sheldon Taub, MD. Gastroenterologist at Jupiter (Fla.) Medical Center: I am very discouraged about what private practice will look like in 10 years, if it still exists. Between hospital systems and big business buying up practices, the private practitioner may become the lone ranger. The role for the concierge practitioner may continue to exist, but that will be only in selected areas that can afford it. The healthcare system will have to change, and that will depend upon the government to get more involved. I anticipate the motivation to go into medicine will continue to decline. The outlook for healthcare in this country is in question.

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