Physicians leaving private practice for employment has hurt patient care quality, according to a recent survey of doctors commissioned by the Physicians Advocacy Institute.
The survey polled 1,000 physicians employed by insurers, health systems, staffing agencies and private equity firms on how corporate ownership affects their workplace experience and ability to meet patients’ needs. The research was conducted by NORC at the University of Chicago.
Nearly 60% of physicians said the trend toward employment has reduced patient care quality, largely due to a lack of clinical autonomy and an increased focus on cost savings by facility leadership, said Kelly Kenney, CEO of the nonprofit institute.
“Physicians feel very strongly about keeping their autonomy, their ability to make the best clinical decisions for their patients,” Kenney said. “So when there are policies in place that put corporate bottom lines first, that can really run up against the oaths that they took.”
Employers’ policies around patient-centered care, quality performance indicators and costs add to pressure physicians face, along with obtaining prior authorizations to get the right procedure or medication approved for their patient, she said.
Around half of survey respondents said practice protocols or incentives have led them to adjust a patient’s treatment options to reduce costs.
However, 18% of the physicians said changing ownership structures have meant investments in technology, implementation of quality improvement programs and integration of multidisciplinary care teams.
Of the physicians who left private practice for employed positions, 55% reported being satisfied with their decision to leave, citing improved work-life balance, increased compensation and less time spent on administrative tasks. More than half said private insurers’ payment and contracting policies drove their transition into employment.
In 2022, 47% of physicians worked in private practices, compared with 60% of physicians in 2012, according to a report earlier this year from the American Medical Association.