Changes in modern society did away with the individual family doctor who made house calls more than a generation ago.
Changes in modern health care services now are threatening to do the same thing for doctors in small medical practices.
Experts say the demise of small practices — or their absorption by larger groups and hospitals — is an unintended consequence of the Affordable Care Act.
Whether this ultimately is good for health care is up for debate.
Attorney John Fanburg, chair of the health law practice at Brach Eichler in Roseland, is living the trend. He has helped negotiate the acquisition of about a dozen physician practices by hospitals around the state.
“For the one-, two- or three-physician group, it’s really hard given the increased overhead and the relatively flat level of reimbursement (from insurance companies, the government, other payers),” he said. “Doctors are talking to everybody all the time.”
They feel they have to.
The new health care reform landscape is leading many doctors to either go to work for a hospital (in the community) or merge into larger practices so they can afford the costly switch to electronic medical records and embrace new care models such as “population health management,” a concept where clinicians engage patients to control chronic diseases.
Hospitals, which previously were happy just to give doctors privileges, are now pushing to have them on staff.
Atlantic Health, which oversees four hospitals — including heavyweights Morristown and Overlook Medical Centers — has been increasingly hiring physicians as employees. It now employs roughly 500 doctors.
And more than a year ago, Atlantic Health launched a new physician-owned primary care practice, Primary Care Partners, which is affiliated with Atlantic but is independent of the hospital system.