Hospitals have virtually given up the search for solo physicians, as an iconic symbol of America’s tradition of independent medical practice fades from the scene, a new survey indicates.
The survey, by Merritt Hawkins, a leading physician search and consulting firm and a company of AMN Healthcare, tracks the 2,710 physician recruiting assignments Merritt Hawkins conducted nationwide from April 1, 2011 to March 23, 2012. Of these, only 28 – or one percent – were for solo physicians. In 2004, by contrast, 22 percent of the firm’s recruiting assignments were for solo practitioners.
“Nobody wants to be Marcus Welby anymore, practicing alone or with a partner, and fewer hospitals are seeking solo doctors for their communities,” notes James Merritt, founder of Merritt Hawkins. “To incorporate required technology, comply with regulations, and participate in new delivery models like Accountable Care Organizations, physicians today almost have to be part of larger practices or be employed by hospitals.”
Indeed, the survey shows that 63 percent of Merritt Hawkins’ recent search assignments featured hospital employment of the physician, up from 56 percent last year and 11 percent in 2004. Should this trend continue, Merritt projects over 75 percent of newly hired physicians will be hospital employees within two years.
The survey also indicates that primary care physicians, including family physicians and general internists, remain the type of doctors in highest demand. For the sixth straight year, family physicians were the firm’s most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons. By contrast, for the first time in the survey’s 19-year history, anesthesiologists dropped from the list of Merritt Hawkins’ top 20 most requested searches. A recession-driven decline in medical procedures and the growing use of certified registered nurse anesthetists (CRNAs) has dramatically reduced demand for anesthesiologists, Merritt says.
The new survey suggests that in addition to practicing in different settings, physicians are being compensated differently. In the 2010/11 survey, fewer than seven percent of physicians were offered bonuses based on the quality of care they provided. In the 2011/12 survey, that number had risen to 35 percent, underscoring a rapid shift away from rewarding physicians for the volume of services they provide and toward rewarding them for the value of services they provide. However, Merritt notes that quality measures generally amount to less than ten percent of a physician’s potential bonus and that volume remains the name of the game.
“The tide is turning, but increasing the volume of services they provide remains the most practical way for physicians to increase their incomes,” Merritt observes.
Complete results of Merritt Hawkins’ 2012 Review of Physician Recruiting Incentives can be obtained by calling Merritt Hawkins at 800-876-0500 or MHA members can contact Julie McNeese at (800) 289-8884, (601) 368-3311 or firstname.lastname@example.org.