The vast majority of Americas physicians still work alone or in small group practices, according to a new HHS survey of office-based doctors.
Even though industry observers say trends suggest many doctors are slowly embracing the system of integrated care provided by big multispecialty groups, the delivery of medical services to most patients still hearkens back to the era of Marcus Welby, M.D., the data suggest. In fact, about 69% of office-based medical practices consisted of solo practitioners, according to estimates from 2003 and 2004 by the National Ambulatory Medical Care Survey.
In all, the study says, there were about 161,200 office-based medical practices in the U.S. with approximately 311,200 physicians. About one-fifth of medical practices contain three or more physicians and make up about one-half of all office-based doctors. Among major specialties, psychiatrists were most likely to operate as solo practices (85.6%), while pediatricians were least likely to go it alone (52.1%). Of the nearly 70% of medical practices involving solo physicians, the most-common specialties were general and family practice, internal medicine, obstetrics and gynecology.
The study also found that about 15% of medical practices used electronic medical records, and that about 6.5% used computerized prescription order-entry systems.
A recent report with more current data from the Chicago-based American Medical Associationthe nations largest doctors groupreinforces the findings of the federal study. The AMA survey, which includes statistics from 2005, provides a slightly different perspective because it defines a medical group practice as three or more physicians. About 40% of all groups, the AMA found, consisted of three or four doctors, and about 62% of doctors practices include three to six physicians. Less than 2% of doctors practices have 76 or more physicians, according to the AMAs study.
The statistics in the HHS report contradict the view of many doctors and administrators in medical groups who say they use the advantage of size, economies of scale and financial clout to provide higher-quality care in a more efficient manner. They are also more likely to enjoy the fiscal resources needed to purchase expensive information technology products, proponents say.
Multispecialty medical groups are the right model for our healthcare system, Mark Mantei, chief operating officer of the 250-physician Everett (Wash.) Clinic, said recently at the annual conference of the American Medical Group Association, which represents most of the nations biggest medical groups.