Nonphysician practice ownership worsens quality of care

Nearly 60% of physicians believe that nonphysician ownership of practices results in a lower quality of patient care, according to a survey from NORC at the University of Chicago. 

The survey, which was commissioned by the Physicians Advocacy Institute, surveyed a sample of 1,000 physicians employed by a hospital or health system, venture capital or private equity firm, health insurance company or subsidiary, or staffing agency from July 17 to Aug. 7. 

Only 18% of respondents believe that corporate ownership of medical practices has improved quality of care, citing greater investments in infrastructure and technology and an increased focus on patient-centered outcomes as benefits. 

Physicians cited decreased time with patients and a greater focus on financial success as the top issues negatively impacting the quality of corporate-owned practices. 

The survey reveals that employed physicians believe that corporate ownership lessens the patient-physician relationship and impacts patient outcomes. 

Employed physicians believe that corporate ownership lessens their clinical autonomy, with 61% saying they have moderate or no autonomy to make referrals outside of their practice or ownership system, and 47% reporting policies or financial incentives to adjust patients' treatment options to reduce costs, including lower cost drug therapies (45%). 

About 70% of physicians employed by corporations say their employer uses incentives or penalties to have physicians see more patients per day.

Physicians who moved from private practice to employment made the change to improve work-life balance and increased compensation, citing declining government reimbursement and private insurers' payment and contracting policies as key factors. About 55% of these physicians report continued satisfaction with their decision to leave private practice.

Physicians working for corporations also expressed frustration around having minimal input on practice management policies and decisions, burdensome electronic health record processes and issues of hiring and administrative support. 

Around 60% of physician respondents were required to sign a noncompete, limiting their ability to practice locally.  

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