Independent physicians across the country continue to experience changes to the way we practice. While the public might think the most significant changes are driven by new medicines or technologies, the increasing rate of hospital consolidation is perhaps the most pressing threat we face today.

As the healthcare landscape evolves, challenges to our daily practices include frequent government-mandated changes, insurer intrusions and ever-changing marketplace dynamics. Currently, we are being confronted with the ongoing monopolization of healthcare by hospital systems aggressively acquiring independently-run physician practices. For those of us who are committed to treating patients in our communities, these mergers are occurring at an alarming rate.

Many physicians believe that by selling their practice, they eliminate practice management headaches. That’s not always the case. Employed physicians often have to manage staff, but now they may be beholden to staffing decisions they wouldn’t have made themselves and often miss the flexibility of making choices without interference or approvals. Decisions made within a corporate structure are centralized and usually driven by cost, not quality. For example, physicians may not be able to reward individual contributions (such as by giving a bonus for a job well done) or may be forced to work with a staff member who doesn’t fit into the practice’s culture.