Monovo reposted this
A Quiet Crisis is Getting Louder - Regulatory Capture and the Destruction of Private Practice Private practice medicine has been the backbone of personalized, community based care for decades. Physicians are leaving independent practice for employed positions, not by choice, but because they're forced financially or operationally. Autonomy is eroding. One of the less discussed but deeply impactful forces accelerating the consolidation of medicine is...REGULATORY CAPTURE. You may be thinking...regulatory capture only happens in "Startup land"? (Bryan Lord what do you think?) Or in banking? (where we have seen incredible consolidation into the BIG 10 banks, evaporation of regional banks, and zero new banks) But YES...we're seeing it in healthcare as well. Regulatory capture in medicine happens when large hospital systems, insurance companies and government influence policies to create an environment that benefits them at the expense of others. For example... 📎 Increasing administrative burdens...complex billing codes, expensive EMR requirments, preauthorization and documentation have made it difficult if not impossible for small practices to manage without significant infrastructure and staff investment. 💰 Reimbursement structures, declining professional fees and decreased bargaining power favor large institutions while squeezing independent practitioners. 🛒 Market consolidation allows hospital systems, insurance companies and local goverments to dictate terms to physicians which reduces decision making, reduces competition and drives up costs for patients. And PATIENTS are effected as well! 🎯 Less competition with higher healthcare costs. 😷 Decreased patient choice. 🙋♂️ Lack of personalized care. How do we change this? Policy makers need to ensure there is equity not monopoly. Physicians must advocate and challenge policies that put profit over care. Patients need to understand how regulatory capture effects their care and their choice. 🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆🏆 Private practice is not just a business model in healthcare...it is a safegaurd against a system that prioritizes bureaucracy over the patient-physician relationship. By watching the machine grow, we lose more than small businesses, we lose what makes healthcare human. #regulatorycapture #healthcare #hospital #doctors #burnout #leadership
Thank you for calling attention to this critical issue. The loss of private practice isn’t just about physicians—it’s about patients, too. When autonomy erodes, costs rise, choices disappear, and the kind of personalized care we all value starts to fade away. Fixing this will take all of us—policymakers, physicians, health advocates and patients—working together, and voices like yours are so important to leading the way. At Monovo, we’re committed to helping physicians keep their autonomy and focus on what really matters: their patients. Let’s keep working toward a future where private practices thrive and the patient-physician relationship is at the heart of care!
Interesting to see this. I worked for an eye doctor 2013-2015. I distinctly remember this topic being broached. He commented how smaller doctors are being pushed to close because they can't compete. That was in 2015.
#DOGE
Open To discuss the collapse on PopHealth Week? https://www.healthcarenowradio.com/programs/pophealth-week/
For obvious reasons I have nothing to contribute to this conversation! The problems facing healthcare seem monumental everywhere regardless of the system and I worry about my friends that work in healthcare for sure. I hope you and others will keep asking these important questions and that solutions will be found.
Erik Pearson, MD FACS well said! The last decade of consolidation has lead to precipitous loss of physician independence and unrelenting health care cost increases #vbc #valuebasedcare #advancedprimarycare Greater Cincinnati Employers Group on Health
Get used to it bubba. There’s no stopping it. I think the main reason is for the govt to eventually control us and capture every penny made so we pay the max amount of taxes.
Erik Pearson, MD FACS - You are absolutely right! To add, the professional fee schedules were released before the holiday. Shocker - it's another decrease! Let me know if you have time to chat. I have a few ideas I'd like to get your opinion on to help innovate and counteract these situations for practices.
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2wPrivate equity is the quiet cancer that is having some of the worst effects on our healthcare system that most people can’t see. Not just taking over independent practices but even emergency rooms. I watched a lecture by a surgeon to residents that warned them against letting PE pitch them when they graduate. His first practice was acquired by PE. He said the hiring process of new docs became strictly based on volume. The pressure the surgeons are under once the PE takes over puts the care of the patient is secondary, if not tertiary. This leads to other cost cutting pressures that discourages doctors from using newer and better technologies/implants/products on their patients. There needs to be transparency available to know if a patient is going in for surgery does a PE firm own that business (surgery center, etc). Even scarier, and moving beyond the independent practices it has eroded ERs. We see the consequences everyday. Ask the staff at St. John Detroit about TeamHealth, a BlackRock subsidiary: Doctors, nurses walk out on strike at Ascension St. John in Detroit https://www.freep.com/story/news/health/2024/04/19/doctors-nurses-walk-out-on-strike-at-ascension-st-john/73375794007/