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Celebrating Independent Physicians: Top 3 Challenges of Practicing Independently

The number of hospital- or corporate-employed physicians showed a 12% increase in the 2 years prior to January 2021. At the same time, the number of physicians in independent practice has been decreasing at a rapid pace. However, physicians who have remained in private practice often enjoy greater flexibility in their practice of medicine than those in corporate or hospital settings. They often have opportunities for deeper relationships with patients within their communities.

In our most recent blog article, “Celebrating Independent Physicians: Top 3 Benefits to Practice Independently,” we take a deeper look at these and other benefits physicians in independent practices experience. By staying independent, practitioners can achieve benefits that can help improve both patient and provider satisfaction—but independent practice brings challenges as well. Keep reading to learn the most common challenges faced by independent practitioners today.

Challenge #1: Creating economies of scale while preserving career autonomy

To run a thriving practice, physicians are often faced with the question of how to balance it all. Joining independent practices to corporate structures or hospital organizations may provide economies of scale that can make it easier to deal with administrative tasks, maintain adequate IT support, reduce cost, or deal with other challenges. However, doing so can diminish career autonomy often desired by independent physicians. Some factors affecting this loss of autonomy and physician happiness levels include the loss of influence on the number of hours, worked; allocated time with patients, and other important professional day-to-day decisions.

Not only that, but there is not always a reduction of cost with the combining of practices. For instance, one study showed that increased patient volume in one hospital department was associated with an increased per-patient cost in another department.

Research also shows that there may not be a correlation between increased patient volume and improved health outcomes. Many policy initiatives rely on the premise that high-volume healthcare providers can deliver better care, by exploiting economies of scale when caring for their patients or improving their patient care skills through increased practice. However, it is important to note that creating economy of scale does not always improve the quality of care your patients receive.

Challenge #2: Administrative and regulatory burdens

Today’s medical practices also face increasing administrative and regulatory demands, such as growing coding requirements and the need for prior authorizations. It is increasingly difficult for independent practitioners to accommodate these demands in addition to their clinical responsibilities. It is estimated in a recent study by the American College of Physicians, that physicians and staff spend an average of 3–5 hours per week on administrative tasks, with some estimates as high as almost 9 hours a week. Independent physicians must find ways to reduce the impact of administrative tasks to free up their time like the implementation of a quality electronic health record (EHR) system.

According to a poll by the Medical Group Management Association, 33% of medical practices had physicians retire early or leave due to burnout in 2021. In the same poll, the top reasons physicians were leaving is due to administrative and paperwork burdens, EHR fatigue, and a loss of work–life balance. With many factors weighing in on physician’s burdens, independent physicians often look to partner with larger health systems to help alleviate these administrative burdens.

Independent practices also face the challenge of dealing with government and insurer payment policies that are more favorable to larger health systems. This can make it difficult for independent practices to measure and report quality metrics as well as larger organizations; however, independent practices can take steps to overcome this challenge by implementing EHR systems that support their needs. In a recent study, 89.9% of physicians reported using an EHR or EMR system. Many EHR systems today also include features that help with measuring, tracking, and reporting key quality metrics.

Challenge #3: Changes in consumer expectations

In response to the global COVID-19 pandemic, the healthcare industry quickly implemented new and innovative solutions to meet the emergent needs of the public, thus changing the landscape of patient care and patient expectations. According to McKinsey & Company, telehealth saw an immediate upswing in utilization with overall telehealth utilization for office visits and outpatient care 78 times higher in April 2020 vs. February 2020.  While it is now reported that telehealth trends have stabilized, the utilization rate is 38 times higher than pre-pandemic. This is just one area that consumer expectations are shifting.

Independent practitioners are especially challenged by a consumer market that is becoming accustomed to the technology and conveniences offered by larger, consolidated medical groups and hospitals. More and more medical groups are offering increased convenience for patient visits and communication, such as:

  • Technology enabling patients to schedule their own appointments
  • Technology allowing virtual communication
  • Technology permitting telehealth visits
  • Alternative methods of care
  • Nontraditional care delivery (e.g., urgent care)
  • Options for reduced healthcare costs

Independent practitioners must now consider how to incorporate these new tools into their practices to not only meet the changes in consumer expectations but also to compete with large care organizations.

The champion for independent medical practices

Allscripts is aware of the significant challenges faced by independent medical practices today—and works to champion independent practices in the face of those challenges. Allscripts works with independent physicians to provide insightful and intuitive solutions and services that empower independent practitioners to successfully bring medical services to their patients.

Learn more about how Allscripts solutions and services are the right fit for independent practices in the next blog in the series: Celebrating Independent Physicians and visit for more information.

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