The Changing Marketplace and its Impact on Physician Employment and Practices

By Thomas A. Lerner | Related Practice: Health Care

This article originally appeared in the King County Medical Society Bulletin.

Twenty years ago, health care practitioners witnessed a trend towards practice consolidation with medical management companies and institutional health care. The idea was to create a feeder system from primary care practitioners to specialists and hospitals. Productivity in that setting was increasingly gauged by the brevity of patient visits, the size of patient panels and volume.

Perhaps not surprisingly, the years since have seen a growth in physician dissatisfaction with the way that their practices have evolved. Few doctors chose to become physicians because they relished the prospect of interacting with health insurers, and non saw themselves as Charlie Chaplin's character in Modern Times, albeit with a stethoscope instead of a wrench. This dissatisfaction by the practitioner was met by every other participant in the system--patients, employers, insurers and government, all of whom believed that the cost of medical care was too great, and accessing that care was too complicated, all the while taking the quality of that care for granted.

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