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Today physicians are much more likely to be part of a group practice rather than a soloist. If you believe the trend, practicing on your own seems as antiquated as house calls paid in cash. The perception (and often reality) is that larger practices have the leverage to negotiate with insurers, leaving the dwindling number of single practitioners in the minority. Health care reform and other challenges mean the solo practitioner must ask themselves tough questions about whether to solider on solo or consolidate. Is the trend to sell your practice to a hospital and become part of its contracted staff the right option for you?

Financial pressures may make it seem like the only viable option. In fact, according to a survey of 118 hospital administrators by Jackson Healthcare, 70% of hospital practice acquisitions were the result of physicians coming to them looking to sell rather than the other way around.

Still, that doesn’t mean remaining autonomous isn’t an option. Many hospitals are willing to work with physicians who wish to remain independent, simply contracting their services between the hospital and the independent practice. Different models offer greater or lesser autonomy and financial benefits, and generally, more autonomy means less financial reward, and vice versa. It’s important to consider all possible scenarios before making a decision.

Limited autonomy may mean a physician is paid based on a system of call-coverage stipends where the hospital compensates him for working on unassigned emergencies.

Moderate autonomy can offer certain services to solo practitioners for a fee, such as human resources, revenue-cycle management, or information technology. The cost of any service that an independent physician requires could be negotiated with a hospital in exchange for services or for a specific price.

Full alignment means the hospital has most of the control and the physician little autonomy, but this can work in many different ways based on individual need. Practices can remain their own legal entities and simultaneously divide payments from hospitals as appropriate.

Fluctuating trends in private practice autonomy doesn’t mean you necessarily have to give up your independence completely to keep your business financially afloat. Sometimes a partnership is a better option for everyone involved, so be careful not to make any decisions until you have carefully researched all options.

Still not sure what is best for your practice?  Donna Bak can provide expert counsel and help you explore these options in depth.


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