This story confirms a trend that is going to be hard to reverse—the disappearance of the private practitioner.

As has been reported here countless times, until the reimbursement schedules reflect the intensive work primary care physicians do with patients and until the paperwork hassles cease to be a high overhead cost to these practices, these small groups will continue to vanish before our eyes.

One of our favorite medical bloggers,  DB’s Medrants, has written that it is imperative that we “fix the job.” He says students love their internal medicine rotations. They simply cannot envision a career in which they would have to work under the present circumstances for primary care physicians. Work harder. Longer. Get paid less for it.  Add to that crushing medical education debts, and the lower pay is a deal-breaker for the next generation of doctors.

The New York Times

“A quiet revolution is transforming how medical care is delivered in this country, and it has very little to do with the sweeping health care legislation that

“But it could have a big impact on that law’s chances for success.

“Traditionally, American medicine has been largely a cottage industry. Most doctors cared for patients in small, privately owned clinics — sometimes in rooms adjoining their homes.

“But an increasing share of young physicians, burdened by medical school debts and seeking regular hours, are deciding against opening private practices. Instead, they are accepting salaries at hospitals and health systems. And a growing number of older doctors — facing rising costs and fearing they will not be able to recruit junior partners — are selling their practices and moving into salaried jobs, too.”

Source: New York Times, March 26, 2010