Guest Post: Andrea Clement
Across the healthcare industry, private practices are shrinking as a proportion of total healthcare facilities nationwide. Over the past decade, many private practices have been acquired by larger health systems, while other practices have shut their doors due to retiring physicians, or doctors leaving to practice with larger practices or hospitals. The AMA recently reported that “most U.S. physicians providing patient care are now working outside doctor-owned medical practices, according to data the AMA collected from 3,500 physicians in the 2020 Physician Practice Benchmark Survey conducted” in the fall of 2021.
Many physician practice owners enjoy the autonomy of private practice ownership and the opportunity to form meaningful, lasting patient relationships long-term.
Why has physician employment grown, while practice ownership by physicians has declined?
Physician ownership of private practices has been on the decline for years, and recently the volume of physician-owned practices was surpassed by employed physicians. The private practice model is becoming increasingly difficult to maintain competitively, due to declining insurance reimbursements, increasing overhead, and the sheer volume of patients required to make ends meet.
While large systems provide numerous benefits such as access to extensive resources including the latest technology and a variety of sub-specialists, private practices arguably provide numerous benefits to their patients as well. A private practice setting tends to be more conducive to a patient-centered approach to care, due to the size of the practice and patient base. In a smaller private practice, physicians and providers can more easily get to know who their patients are – rather than each patient being one of thousands who come through the door.
Despite the recent stagnant growth of private practices industry-wide, some healthcare leaders see trends that they believe are glimmers of hope for the future of the private practice model.
“I believe that functional medicine could save the private practice model of patient care from a continuing decline in viability,” said Lisa McDonald, founder of Integrated Connections, a firm that provides career and practice growth resources to functional medicine practitioners nationwide. McDonald’s firm has observed exponential growth in functional medicine, including increased volume of listings on the Integrated Connections online job board for practice opportunities in functional medicine, most of which are in private practice settings.
While some larger health systems are starting to explore and take steps to integrate functional medicine into their patient care service lines, “private practices have already been hiring functional medicine practitioners at an increasing rate over the past 2-3 years,” McDonald explained. She feels that this growth shows that Functional Medicine and the private practice model are a successful combination for FM physicians and other providers of root-cause / personalized medicine in the healthcare industry.
In 2021, 84% of the open positions advertised for integrative and functional medicine providers were to hire practitioners to work in private practice settings, according to McDonald, based on the annual data collected from the Integrated Connections job board.
Overall, the volume of job opportunities in functional medicine grew by 141% in 2021, and private practice opportunities in FM grew by 120% year over year.
McDonald feels that the patient demand for personalized care is driving growth, as well as the increase in chronic disease among the patient population nationwide.
Many physicians who enter the functional medicine field do so out of a desire to treat patients in a more personalized, individualized way. “Physicians who practice root-cause medicine prefer to spend more time with their patients, so they can get to know more about the potential factors impacting their overall health. This empowers physicians to treat their patients holistically, and consider all factors of each patient’s biology, genetics, symptoms, and systems,” McDonald states.
Functional medicine allows physicians to provide more patient-centric care that is not “one size fits all” rather than forcing physicians to treat each patient within a 15-minute office visit that is common in many conventional medicine settings. Thus, for functional medicine practitioners, a smaller private practice may offer more flexibility and autonomy.
The healthcare industry must be able to serve all types of patients to meet each of their unique and often complex medical needs. Patients may respond differently to any given approach to medical care and treatment regimens. Therefore, patients benefit significantly when they are able to choose from a variety of practice settings for their care.
“For example, if I need open heart surgery, I’d want to receive medical care from the health system with the best heart program. However, if I’m suffering from chronic pain or illness, I may want to see a practice with physicians trained in integrative or functional medicine, who can take the time to understand my unique needs as a patient including biologic and genetic predispositions, lifestyle, health habits, and risk factors to provide the most personalized medicine possible for the specific underlying root cause of my symptoms,” McDonald explained.
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Integrated Connections is a leading provider of career development, job search, and practice growth resources in functional and integrative medicine. We provide a number of professional services and tools to a variety of practitioners and medical practices, including small independent groups and large health systems. For career resources, visit our job search center, and for practice management and staffing resources, review our employer page.