Why Physicians Won't Unite to 'Rescue' Medicine

Leigh Page

Disclosures

September 04, 2014

In This Article

Employed Physicians Have a Different Mindset

One of the biggest challenges to organized medicine is the emergence of employed physicians, who now make up almost one half of the profession. The AMA's latest survey in 2012[11] found that 47% of US doctors were employees or independent contractors, up from under 25% in 1983, and some observers think employed physicians are now in the majority.

Certain categories of physicians are more likely to be employed. The AMA survey showed they were more likely to be in primary care, and another survey[12] released by Medscape this March found that female and younger physicians are more likely to be employed.

One challenge about employed physicians is that they are less likely to join physicians' organizations. According to a 2013 survey[13] of 14 state medical societies, the societies tended to attribute membership losses to lack of interest by employed and younger physicians.

Many employed physicians "don't care about organizations," said Aaron M. Roland, MD, a family physician who owns a 5-physician practice in Burlingame, California, an area with a large majority of employed physicians. Payment issues don't interest them much. "They are divorced from the consequences of the insurance industry because they aren't directly confronting them," he said.

There may also be other differences in mindset. Dr. Scherz said employed physicians have different priorities from self-employed physicians. Whereas self-employed physicians are under pressure to make sure their business stays in the black, employed physicians are under pressure to play a cooperative role inside the greater organization. "Instead of asking what's good for the practice," Dr. Scherz said, "they are asking, 'What's good for the organization?'"

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