Becker's ASC Review

44 HEALTHCARE NEWS Less than half of physicians are in independent practices By Laura Dyrda F or the first time, less than 50 percent of physicians reported working in physician-owned practices last year, according to a May 5 American Medical As- sociation report. e AMA surveyed 3,500 physicians in September and October 2020 about their employment and practice situations. Five findings: 1. Forty-nine percent of physicians worked in wholly physician-owned practices last year, in- cluding 38.4 percent who are practice owners. 2. Since 2018, the number of physicians in private practice dropped 5 percentage points. 3. Sixty-six percent of surgical specialists are in private practice. 4. One-third of physicians younger than 40 were in private practice. 5. Forty-three percent of physicians worked in single-specialty practices, and 26.2 per- cent worked in multispecialty groups. Few physicians attributed changing employ- ment status to the pandemic, indicating a larger trend away from physician ownership, the report said. ASC leaders in markets across the U.S. face challenges finding new physicians for their centers as independence wanes. Brian Bizub, CEO of Raleigh Orthopae- dic, said that while communities in North Carolina are growing rapidly, there has been a shi away from private practice to hospital employment. He said reimbursement de- clines in private practice make it difficult to manage overhead, and the referral networks are drying up as primary care physicians become affiliated with hospitals. "e current state of healthcare reform is creating uncertainties, and the shi in physi- cian preferences are leaning toward hospital employment over private practice," he said. "Recent trends and published studies clearly show that younger physicians are inter- ested not only in practicing medicine, but maintaining a quality home life as well. Less interest exists in physicians seeking admin- istrative tasks and concerns with overhead and payer reimbursements." His group has been able to maintain private ownership because of collaboration with a local health system to become part of its referral network. On the other hand, some communities are seeing a spike in the number of physicians interested in ASCs. Danilo D'Aprile, admin- istrator of Danbury, Conn.-based Ortho- paedic Specialty Surgery Center, said more physicians have requested center credentials since the pandemic began, especially for total joint replacements. "Our total joint replacement program is very robust," he said. "We are in a good position to attract a lot of these doctors, and I have a lot of physicians coming to me to request privileges and ownership because they want to be here." n 10 states with the fewest employed physicians By Laura Dyrda S outh Dakota has the fewest employed physicians, according to the U.S. Bureau of Labor and Statistics occupational employment statistics survey. The survey data, released March 31, comes from information gathered in May 2020. The data does not include pediatric ophthalmolo- gists or self-employed physicians. Ten states with the fewest employed physi- cians: 1. West Virginia: 1,910 2. New Hampshire: 1,680 3. Idaho: 1,410 4. Delaware: 1,380 5. North Dakota: 1,320 6. Montana: 1,130 7. Vermont: 780 8. Alaska: 660 9. Wyoming: 470 10. South Dakota: 390 n Physician noncompete clauses: 4 observations By Laura Dyrda Physician noncompete clauses are common, and getting out of them is a challenge, according to a report from Medscape. Hospitals and practices that invest in recruiting and training physi- cians can use noncompete clauses to prevent physicians from leav- ing their organizations before their contract is up. Medscape conducted a poll of 558 physicians and found: 1. Ninety percent of respondents were bound by a noncompete clause in their contracts, or had been bound by one in the past. 2. Twenty-three percent of the respondents said they tried to negoti- ate out of a noncompete agreement but were not successful. 3. Thirty percent of respondents said they didn't try to negotiate out of the noncompete agreement. 4. Among the physicians who left a job while under a noncompete agreement, 42 percent were able to work in a similar position out- side the noncompete restrictions. Another 6 percent found a differ- ent type of work. n

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