During MedPage Today‘s annual salary survey, our enterprise & investigative reporting team always asks for story ideas and trends that we should be looking into — and every year, a majority of these tips involve the corporatization of medicine, and the resulting waste, greed, and harm.
Doctors lament the vast amounts of money spent on C-suite executives and administrators; the middlemen like pharmacy benefit managers that siphon too much cash from the system; hospitals mandating in-system referrals at the expense of quality; colleagues being silenced for speaking out against injustices; and so on.
Overall, physicians tell us they feel they have less and less control over the practice of medicine as business interests supersede patient care concerns.
Although this evolution has happened over decades, the profession reached a clear tipping point this year when the American Medical Association’s biennial private practice survey dipped below 50% for the first time since its inception nearly a decade earlier.
This milestone suggested it’s as good a time as any to examine healthcare ownership trends and the impact they’ve had on the way physicians work today.
In our main story, reporter Jennifer Henderson provides a thorough analysis of current trends and where they’re headed. Large healthcare systems are only getting bigger. Interest from new employers in healthcare, like insurers and private equity, is only expected to grow. Employment-based incentives are growing more appealing.
Physicians and economists agree that “consolidation, financial pressures, changing generational perspectives, and the pandemic will continue to drive and accelerate the trend toward employment,” Henderson writes. “But that doesn’t mean an industry-wide shift to one way of practice is what’s best for doctors and patients.”
What is best for doctors? Many have told us that they want autonomy — being able to make the best decisions for patients without outside influence. Reporter Amanda D’Ambrosio explores the concept of what that autonomy actually looks like in practice and finds it’s a highly personal concept. Universally, however, doctors strive to find it, no matter their employment situation.
As for what’s best for patients, concerns have been raised about how focusing on business incentives impacts decisions made about their care. Large health systems are big businesses, as are the new employers on the scene: the insurers and private equity. Reporter Kara Grant focuses on the latter group and the key issues — particularly around both patient care and physician workload — that have surfaced in the decade that private equity groups have become substantially more involved in healthcare.
There’s no doubt that medicine will continue heading toward increased corporatization, and MedPage Today will remain a voice for physicians on all workforce issues. Stay in touch with us by emailing [email protected], and if you’d like, take our survey on a related topic that we’ll be reporting on soon: work-life balance.
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