Loss of autonomy a top concern among physicians working for private equity or other corporate owners

Nearly 60% of radiologists and other physicians reached in a recent survey said that reduced autonomy was one of the top negative impacts of corporate practice ownership.

Another two-thirds of physicians reported having little or no involvement in practice management policies, while 70% said such employers used incentives to encourage docs to see more patients.

The findings are derived from a survey of 1,000 physicians employed by hospitals, health systems, venture capital and private equity firms, health insurers, and staffing agencies. Nearly 50% of respondents worked in pediatrics, family and internal medicine, while 3% practiced radiology.

“The patient-physician relationship is the foundation of our healthcare system,” Kelly Kenney, chief executive officer of the Physicians Advocacy Institute, which commissioned the survey, said in a Dec. 4 announcement. “With corporate ownership comes a higher emphasis on financial outcomes and shareholder returns. This focus on the bottom line can interfere with best clinical practices.”

Only about 18% of those surveyed said corporate ownership improved quality of care. On the administrative side, 40% of physicians expressed dissatisfaction with workforce-related issues such as hiring, management and admin support. However, respondents reported high satisfaction with other factors including medical equipment (53%), technology training (36%), along with policies and procedures related to IT/EHRs (37%). “Interestingly,” the authors noted, 52% of physicians said they were unaware of the formal process to resolve workplace disputes.

The survey also explored reasons why physicians moved from independent practice to corporate employment. More than half (53%) cited government and private insurer reimbursement cuts as driving factors in making the decision. About 60% said their corporate employer required them to sign a noncompete clause. Another 44% said they would consider joining a union if the option was available, and 74% cited burnout as the most common reason they might seek an early retirement.

NORC at the University of Chicago conducted the survey in July and August on behalf of the lobbying group, targeting those who dedicate 50% or more of their time to patient-facing activities. The Physician Advocacy Institute contended that key decision-makers should pay attention to these findings, particularly as they relate to patient care.

“As the structure of medical practice fundamentally changes, healthcare leaders and policymakers have a responsibility to make sure patients and their physicians remain at the center of healthcare,” Kenney said in the announcement. “New insights on the employed physician landscape can shape crucial policy decisions in the future.”

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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