A new national survey of physicians' groups underscores a maxim as ancient as medicine itself: There's strength in numbers.
Indeed, an overwhelming 86% of respondents agreed that the group-practice model had enhanced their overall quality of life, according to the survey conducted by the American Medical Group Association and MedTactics, an Arlington, Va.-based consulting firm. What's more, 92% of the respondents agreed that group practices contributed to improved patient care, and 84% said it added to their professional development.
The results of the survey, based on 249 responses to a questionnaire published in the October 2000 issue of the AMGA's Group Practice Journal, cast a positive light on a troubled institution that has suffered more than its share of bad publicity and business setbacks in recent years.
"When this survey was hatched, we felt that a lot of medical groups were in deep trouble-there were all kinds of failures and physicians leaving practices," said Steve Messinger, a partner in MedTactics who conducted the survey. "We wanted to find out what the physicians' perceptions were of the group-practice model. What we found is that physicians almost universally believe that there is great value in a group-practice model."
Messinger said one key finding may be the sense by an overwhelming number of respondents that patient care is improved in group practices, which boast the kind of continuity and quality initiatives that solo practitioners often cannot provide. In addition to those factors, physicians in group practices aren't distracted by day-to-day administrative duties, he said.
"Basically, they feel like they've got the ability to spend more time on patient care," Messinger said. "They talk about their ability to work in interdisciplinary teams and to take advantage of their colleagues' expertise in the group. And they have better access to high-cost technologies that you typically don't see in a solo-practice environment."
David Gans, survey operations director at the Englewood, Colo.-based Medical Group Management Association, said Messinger's study "parallels much of the information we have found anecdotally" about how physicians view the benefits of the group-practice model, especially in terms of clinical-care quality.
The survey was released during the AMGA's annual conference last month in Florida and was featured as the cover story in the February edition of Group Practice Journal. In addition to the other findings, the survey sought to identify ways in which group practices could cope with typical problems, including the often-tense relationship between leadership and "lay" physicians. Among the none-too-revolutionary suggestions: regular forums to help improve communication.
"One of the challenges of leadership in medical groups is communicating with practicing physicians," said Donald Fisher, president of the AMGA, which represents about 250 large multispecialty medical groups with about 67,000 physicians. "These results give medical group leaders guidance as they struggle to sustain vital, successful healthcare organizations."
The survey found that "quality of life" has emerged as one of the most important variables for physicians in group practices. Many doctors-especially younger ones-view employment with a group practice as the best way to maintain the semblance of a normal life. These physicians are "interested in lifestyle issues" rather than "maximizing earnings," Messinger said.
That factor is increasingly important, Messinger said, because most physicians-about 52% of those surveyed-believe they will earn less in a group practice than they would as solo practitioners. Although 68% of the respondents said they felt their group's overall compensation system was fair, only about 48% of practicing physicians who were not in a leadership position said they were satisfied with their compensation.
For the most part, Messinger blames that discontent on human nature.
"Typically, if you ask any physician in any environment, they would say, `I'm not satisfied with my compensation,' " Messinger said. "The issue is that anytime you ask someone, they're likely to say, `I wish my compensation was higher.' Doctors are no different."
In fact, studies by both the American Medical Association and the MGMA, which represents about 170,000 practicing physicians working in 5,500 medical groups, show that doctors in group practice usually earn more than self-employed physicians. The AMA's recently released Physician Socioeconomic Statistics 2000-2002 Edition indicates that the median income for solo practitioners was $150,000 in 1998. Physicians in all sizes of group practices, from two to eight and more, all earned higher salaries.
"In general, due to economies of scale and the ability to operate their own ancillary services, group physicians traditionally enjoy a higher salary than solo practitioners," Gans said.