For many years now the independent practice of medicine, and independent physicians, have been under attack from all fronts. Hospitals and hospital systems have purchased physician practices at an unprecedented rate, so that now the number of physicians who are independent are at an all time low of 60%. And many of those still independent have hospital strings attached, like lucrative medical directorships of hospital programs, and hospital payment of dues and attendance to what have traditionally been physician led organizations, like the AMA.
This consolidation of hospitals and physicians has led to healthcare market domination and a vast increase in the cost of medical care, because hospitals and their employed physicians are paid at a much higher rate than independent physicians out of the Hospital Outpatient Prospective Payment System. In these days of increasing insurance industry consolidation, increasing patient deductibles, and increasing insurance premiums, all this means patients are stuck with increasing out-of-pocket expenses. This means that patients who could afford insurance and medical care in the past, can no longer do so.
This hospital consolidation and acquisition of physician practices has been driven by the resultant profits made by most hospital systems. These profits have sometimes been so egregious that hedge funds have purchased hospital chains.
It doesn’t matter whether the hospital system is for profit (and pays taxes) or not for profit (and doesn’t pay taxes). They otherwise operate the same. And their growth has been facilitated by misguided federal policy, hoping that integration of healthcare by a hospital-centered system would make healthcare affordable and accessible to everyone. But the exact opposite has happened.
Luckily for independent physicians and patients, change may be on the horizon. The recent budget deal by Congress fosters so-called “site neutral” payments for many services as a start. After January 2017 hospitals will no longer be able to buy a physician practice thirty-five miles away and suddenly start charging patients twice as much as they paid before for an office visit, just because that office is suddenly part of the hospital outpatient department.
Because of the pervasive influence of hospitals in national and state organizations that traditionally have been physician-oriented, independent physicians need their own, undiluted voice. They need a forum to express ideas that are patient-centered, and that don’t have to be okayed by hospital CEO’s. Independent Kansas physicians need an organization to represent them on issues affecting them and their patients. That’s why Kansas Independent Physicians, Inc. was formed.
Vernon Rowe, M.D.
President, Kansas Independent Physicians, Inc.