Private-Practice Medicine Still Going Strong, AMA Finds

The AMA today released new data on physician practice arrangements showing that private-practice medicine remains strong despite an increase in hospital employment. This is the first nationally representative study of physician practice arrangements in five years.

“To paraphrase Mark Twain, the reports of the death of private-practice medicine have been greatly exaggerated,” said AMA President Ardis Dee Hoven, M.D. “This new data shows that while there has been an increase in hospital employment, more than half of physicians (53.2 percent) were self-employed in 2012, and 60 percent worked in practices wholly owned by physicians. Needed innovation in payment and delivery reform must recognize the wide range of practice types and sizes that exist today so all physicians can participate in the move to a more patient-centered system that rewards high-quality care and reduces costs.”

While this study shows 60 percent of physicians in physician-owned practices, there has been a trend toward more hospital employment during the last five years. In 2012, 29 percent of physicians worked either directly for a hospital (5.6 percent) or for a practice that was at least partially owned by a hospital (23.4 percent). A 2007/2008 AMA survey did not distinguish between direct hospital employment and employment in a hospital-owned practice, but found that 16.3 percent of physicians worked in one of the two settings.

For more news from the AMA, see the Psychiatric News articles, "AMA's Psychiatrist President Hails Involvement of APA" and "AMA Releases Insurer Report Card, Award Innovative Schools."

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Q & As from APA’s Practice Management HelpLine

APA’s Practice Management HelpLine provides practical assistance to APA members on a wide variety of day-to-day issues that arise in managing a practice. These include CPT coding changes, reimbursement problems, relationships with managed care companies, documentation of services provided, Medicare, Medicaid, establishing a private practice, and closing a practice, among others. To see recent questions received by HelpLine staff and how they answered them, see Psychiatric News.


APA members can submit their questions to the HelpLine by phone at (800) 343-4671 and e-mail at hsf@psych.org. Questions will be answered in future issues of Psychiatric News.

Private Practitioners Want to Control Costs

Given fixed Medicare and managed care payments, one way physicians can keep their private practices in the black is by identifying costs they can control. These include human-resource expenses, spreading fixed costs out as much as possible, and exploiting the latest information technology.

But how might a psychiatrist harness information technology to control costs? One way is to run nearly the entire practice on a laptop. Psychiatrist Amy Berlin, M.D., who has a solo practice in San Francisco, explained how she does it at this year's APA annual meeting. Read about her nearly paper-free practice in Psychiatric News at http://pn.psychiatryonline.org/content/46/15/11.full.

Some psychiatrists are also getting serious about using electronic health records to save time and space and keep staff costs down. For more information about psychiatrists' experiences in the cyberspace realm, see Psychiatric News at http://pn.psychiatryonline.org/content/45/8/6.1.full.

And more information about how to use technology and the Web to minimize administrative overhead and enhance clinical services is found in American Psychiatric Publishing's Entering Private Practice: A Handbook for Psychiatrists. Purchasing information is available at www.appi.org/SearchCenter/Pages/SearchDetail.aspx?ItemID=62141.

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