Thu. May 9th, 2024

I have been sent this article by the Wall Street Journal by more than a few people. I get the WSJ so I already knew about it. This is the link but it may be behind a paywall for you. Here are the highlights:

  • In 1983, more than 75% of physicians owned their own practices, according to American Medical Association physician surveys. By 2018 that figure had dropped to 46%. Many practices have been purchased by hospitals or have merged to form larger clinics, while local hospitals have been subsumed into large health systems. Consolidation is the trend. An AMA report earlier this year found that for the first time, less than half of doctors work in private practices.
  • The shift from the small doctor’s office to big-box medical care can be attributed to many factors
  • Kathleen Blake, AMA’s vice president of healthcare quality, earlier this year cited studies showing that hospital acquisitions of private practices—which doubled from 2012 to 2018—have led to “modestly worse patient experiences and no significant changes in readmission or mortality rates.”
  • Unlike the book business, however, the replacement of the small doctor’s office with large-scale facilities hasn’t made medicine cheaper or access to it easier. It threatens to remove a core advantage of the small, privately owned practice: the sense of personal, immediate responsibility between physician and patient.

Yup, that was about it. No great answers. Oh wait, there is this:

 In April 2021, the group launched a new initiative to support private practices. 

Really, AMA? od luck with that. I’ll save my money from going into your coffers.

Now I wonder if the author could have mentioned a solution to this mess? I don’t know, maybe….

DIRECT PRIMARY CARE!

49470cookie-checkThe Assembly Line Practice?
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By Douglas Farrago, MD

Douglas Farrago MD is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website Authenticmedicine.com and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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