As they try to figure out how to change things, the outcomes are far from certain:
American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following.
Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years.
Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins.
Health economists are nearly unanimous that the United States should move away from fee-for-service payments to doctors, the traditional system where private physicians are paid for each procedure and test, because it drives up the nation’s $2.7 trillion health care bill by rewarding overuse. But experts caution that the change from private practice to salaried jobs may not yield better or cheaper care for patients.
Removing private health insurance companies from the equation would do quite a bit to provide more care at lower cost.
I’d be willing to bet a lot of them are moving because hospitals have billing departments to deal with insurance companies. There are plenty of new regs attached to Ocare. Fulfilling them might well require doctors to hire yet another back-office worker, plus spend more time themselves. They already spend well over a third of their time on pushing paper instead of helping patients. Add in that there are usually more billing workers in a private practice than medical assistants, and you can see why chucking all that for a regular job would be appealing.