Independent physicians are disappearing — and communities suffer for it

By Dr. Christopher Crow

Every six months, leaders and physicians in the Catalyst Health Network get together to talk over what’s going on in our network and in health care generally. They’re great meetings; I always leave fired up about our work, and I think my fellow physicians do too.

These convenings are especially encouraging at this time when there is so much pressure on physicians to join big hospital systems and affiliated medical groups backed by short-term private equity. Such mergers are driving health care economics in Texas and across the country — and they’re creating big problems for patients, physicians and communities.

It can be awful for patients when physicians have to sacrifice their independence to gigantic, monolithic health care corporations — new management undercuts relationships between patients and the doctors they trust, and it often pushes people into expensive tests and procedures that don’t always improve people’s health but do wonders for a corporation’s bottom line. The mergers can be tough on physicians, too — dictating the amount of time they can spend with patients and forcing them to adopt business practices they don’t like or refer patients to specialists based on affiliations, not ability.

But pressure on independent physicians to merge with big hospital systems is also dangerous for society and the economy.

Just this month, a study by a health economist at Rice University noted that “patients in hospital-owned physician practices pay almost $300 more per year than those in independently owned practices.” But those higher costs don’t buy better care — independent physicians scored at least as well as those in hospital-owned practices on most quality measures.

Unfortunately, consolidations are more and more becoming the rule. According to the study, the share of hospital-owned practices more than doubled in 4 years, and other analyses put the percentage of physicians employed by hospitals at 44 percent or even higher

Catalyst and the company that powers it, StratiFi Health, were built in part to help physicians remain independent. We provide care teams, contracting arrangements, health data tracking and back-end support to help physicians keep their independent practices going in the face of economic winds blowing them toward consolidations.

Six months ago, at our last biannual physicians meeting, a newcomer asked a pediatrician who’d been a Catalyst member for three years how things had changed since she joined the network. She paused, thought about it and said, “It probably saved our practice.” Without Catalyst’s support and StratiFi’ Health’s systems, she explained, her practice probably could not have weathered the brutal economic winds created by insurance companies, referral networks and others that push independent physicians into the arms of hospital systems.

Now, she can practice medicine and treat her young patients, exactly how she wants to. It’s good for her, her young patients and their parents. It means a healthier community and fewer costs for society.

It’s why Catalyst Health Network and StratiFi Health exist.