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Carolina Journal: “Independent doctors: An effort to resurrect a dinosaur”

Carolina Journal posted a story Julie Havlak wrote about Tryon Medical Partners October 16, 2019.

Here are some highlights:

  • When hospitals own primary care doctors, patients feel the difference. Owned primary care doctors face pressure to refer within the system, whether they’re sending patients to the best doctor or not. Patients also face higher costs, as hospitals can charge them extra fees that can total hundreds or thousands of dollars.
  • Tryon’s doctors are bucking a nationwide trend. Only about two in five family physicians are independent, and that number seems to shrink every year.
  • When hospitals gobble up physician practices, prices jump an average 14%, raising insurance premiums and deductibles.
  • By themselves, primary care doctors are worth little. On the ladder of doctors’ salaries, they dwell at the very bottom. There’s a mounting shortage of primary care doctors, as medical students eye the salaries of specialists — who can make almost three times more than primary care doctors — and specialize.
  • But to a hospital, primary care doctors are worth much more.
  • They control referrals. As the first point of contact a patient has with the medical industry, primary care doctors decide where to send patients who need to see specialists, get tests, or receive treatment. They are the gateway to the medical system — and whoever controls the entrance controls the building.
  • If a health system keeps referrals within its system, it can rake in facility fees at each step of a patient’s referral process.
  • “If you have competing hospitals, just like if you have competing hamburger stands, whoever has the best product should win the day, not who puts a fence around the customers,” Owen said. “And that’s what this is really about: not having to compete on quality … it’s truly about captive referrals.”

Read the full article here.