The COVID-19 pandemic and a recent spike in inflation are just the latest in a string of pressures that are increasingly driving private practices in Texas and across the nation out of business – a trend the Texas Medical Association is aiming to reverse through the formation of a new Ad Hoc Committee on Independent Physician Practices.
“TMA leadership has clearly seen that unless we direct concerted efforts and attention to preserving and protecting independent physicians in private practice, we may lose those practice models,” said Bradford Holland, MD, speaker of the TMA House of Delegates. These practices “feel the brunt of any insurance company squeeze or federal pay cut more than anyone. With the formation of this committee, we’ll now have mechanisms to develop policies that bolster private practice.”
The committee, which held it's first meeting in late August, is co-chaired by Fort Worth allergist and immunologist Sue Bailey, MD - past president of TMA and the American Medical Association - and Austin internist Tony Aventa, MD - past president of Travis County Medical Society.
According to a recent study by the Physicians Advocacy Institute (PAI), by January 2021, about 70% of the nation’s physicians were employed by hospital systems and corporate entities like private equity firms and health insurers, representing double-digit growth in these types of acquisitions. Between Jan. 1, 2019, and Jan. 1, 2021, 48,400 physicians left independent practice; about 22,700 of those physicians made the switch after the onset of the COVID-19 pandemic.
The southern U.S. saw the highest increases in physician employment (28.7%) and acquisitions (15.4%), the PAI report found.
Similarly, an analysis by the American Medical Association showed “the majority of patient care physicians worked outside of physician-owned medical practices in 2020,” with “accelerated” shifts between 2018 and 2020 toward larger practice size, ownership that includes mergers and acquisitions, practice closures, physician job changes, and different practice settings.
While the demands on private practice are nothing new, Dr. Holland says the exacerbation of financial stresses during the pandemic coupled with the increasing pace of practice acquisitions have created a renewed sense of urgency to support independent physician practices.
“Every practice model but private practice itself is growing, and we need to do more,” he said. “We want Texas to be the model for how private practice is preserved.”