New Chattanooga-based company helps doctors ditch employment in favor of private practice

Dec. 5--A new Chattanooga-based company aims to reverse the trend of doctors leaving private practice for employment in large groups or hospitals.

The number of hospital-owned physician practices in the United States increased from 35,700 in 2012 to more than 80,000 in 2018. Meanwhile, 44% of U.S. physicians were employed by hospitals or health systems as of January 2018, compared to just 25% in 2012, according to a 2019 report by the Physicians Advocacy Institute. The change comes as hospitals and large groups continue buying smaller practices or physicians -- who may not have a business background -- choose employment over running a practice, which can be less lucrative and carry a high administrative burden.

Practice Management and Resources promises to help physicians in Middle and East Tennessee and North Georgia walk away from employment and into a turnkey practice by securing facilities, equipment, employees and handling administrative duties, such as the tedious process of insurance credentialing. The approximately 60-employee company is led by longtime local health care consultant and businessman Bill Taylor and backed by Nashville-based CRS Health, a real estate development company.

"While the trend has been for hospitals to acquire physician practices, we believe it is more efficient and better patient care in an independent physician practice or small physician group," CRS Health CEO Kenneth Powers said in a press release announcing the new venture.

Taylor said giving doctors the opportunity to practice medicine the way they want to practice is the biggest advantage of the service. It can also improve the patient experience with easier access, shorter wait times and more responsive staff compared to a corporate structure.

"In our client practices, a real person answers the phone and they can in general take care of the call right then," Taylor said.

Research also suggests that patient costs increase in hospital-owned practices compared to physician-owned groups, according to a recent study published in the Journal of General Internal Medicine. The researchers from Rice University attributed the spending difference to greater service utilization rather than higher prices and found "no consistent difference in care quality for hospital-owned versus physician-owned practices."

Dr. Paul Apyan, an orthopedic surgeon who's practiced in Chattanooga for 33 years, has been in both private practice and employment. He said "there are pros and cons to each," but when his employment status changed, he wanted to go back into private practice to "once again have the responsibility and autonomy to handle the business and clinical aspects of medicine."

"Doctors, because of our training, are used to being in charge and having autonomy in the decision making process," Apyan said. "When you're employed, you are at the mercy of an administrator."

Apyan said he's seen the trend of more doctors in employment versus private practice flip-flop over the years, and it's hard to predict what the future holds.

"As health care has continued to evolve, some hospitals have found that employing physicians has not been as successful as they had hoped," he said. "It's a moving target. What it looks like today will not be the same five years from now."

Contact Elizabeth Fite at [email protected] or 423-757-6673.

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