American medicine is moving rapidly from small doctor-owned medical practices to large corporate-run clinics, a trend that will likely mean safer care for patients, but with a loss of close relationships with personal doctors.
Just since 2005, the percentage of doctor-owned practices has declined from over two-thirds to less than half, as doctors face a myriad of financial pressures, according to an article by Gardiner Harris in the New York Times.
Patients typically get better coordinated care in the large group practices now emerging as the model for medical practice. When doctors work together under one umbrella, it’s easier to pass the patient from primary care to specialist to hospital without the communication gaps that cause so many tragedies and give rise to malpractice lawsuits. The larger practices also can better afford the electronic medical record systems that help this coordination.
Big practices also spell loosening of the intimate bond between doctor and patient, just like Costco and Walmart spelled the end of close relationships that many of us had growing up with our neighborhood merchants. But closeness and a sense of trust are much more important to the healing process than buying groceries. So the challenge for medical leaders will be to find ways to keep big medical practices from becoming too impersonal.
Whether this trend will slow rising medical costs is another question. Many of the large companies gobbling up doctors’ practices are monopolies in the towns where they operate, making them more able to resist reimbursement cuts by insurance companies.