Recruiting firm says solo physician practice is dead
It's no secret that solo practice by doctors has been diminishing. But a new finding by recruitment firm Merritt Hawkins declares that solo practice is all but dead.
In its annual review of physician recruiting incentives, Merritt Hawkins found that recruitment of doctors into solo practice settings is nearly nonexistent. Only 1 percent of its search assignments in 2011/2012 (down from 22 percent 11 years ago and 2 percent in last year’s report) were for recruitments of doctors into solo practices.
That recruitment of doctors into solo settings is down is not a surprising finding said Kurt Mosley, vice president of strategic alliances for Merritt Hawkins and Staff Care, companies of AMN Healthcare, a nationwide healthcare staffing organization.
[See also: Doctors leave private practice in droves.]
"It’s not necessarily that surprising, but it dropped so dramatically," Mosley said. "That’s what I think is really the telltale, I guess, the death knoll of the private practice that we’ve seen. As I think (the Merritt Hawkins’ press release noted), nobody wants Marcus Welby any more. That concept doesn’t play anymore and it’s not effective."
As hospitals watch solo doctors closing practices due to financial and regulatory burdens, they do not want to spend the money to recruit a physician into solo practice when he or she may not be able to make it and will shut the practice down in a year or two, Mosley noted.
"When nobody is recruiting them that means that practice style is going away," Mosley said.
Glen Stream, MD, president of the American Academy of Family Physicians (AAFP), does not dispute that solo practices are in distress but he disagrees with the recruiting report’s assumption that a lack of recruiting requests for solo practice settings means solo practice is dead.
"I think it’s way premature to put the nail in the coffin of solo practice," he said. "If you’re really trying to assess what’s the current status of solo practice, you’d have to do a survey of solo practices ... as opposed to using this recruiting information as any reliable proxy for the status of solo practice."
That aside, Stream noted that he wouldn’t discount what Merritt Hawkins’ recruitment report has to say about the employment trends it found.
Trends that AAFP and the healthcare industry as a whole have been watching are reflected in Merritt Hawkins’ report, such as
• Recruitment of physicians into hospital settings continues to grow. Merritt Hawkins noted that 63 percent of its search assignments in 2011/2012 were for hospital employment of physicians, up from 56 percent the year prior and 11 percent eight years ago.
• As the national focus turns to primary care providers, those physicians continue to be the most sought after by hospitals and other medical groups. Family physicians and internists were the most requested recruitment searches.
Other trends noted by Merritt Hawkins’ survey of 2,710 physician and other healthcare search assignments conducted by the company between April 1, 2011 and March 31, 2012 include
• A "silent shortage" of psychiatrists. Psychiatry was the third most requested recruitment search as noted in the recruitment report. Unlike the shortage of primary care physicians, the shortage of psychiatrists is not discussed as much, said Mosley, but it is just as dire a situation as the demand for psychiatry services continues to grow.
• Physician compensation packages continue to replace income guarantees with salaries and, in a nod to the continuing difficulties in the housing market, to offer relocation and housing allowances.
• For the first time since Merritt Hawkins began its recruitment review, anesthesiology was not among the top 20 search assignments. Up-and-coming specialties are in pulmonology, reflecting the higher rates of patients with chronic obstructive pulmonary disease (COPD), Mosley noted, and oncology.
