Dear Private Practice Physicans.

You’ve been bamboozled by the US Government and Big Business.

Dear Private Practice Physicians,

You have been entirely bamboozled by the government and its cozy relationship with the largest corporations.

Medicare has kept physicians on a leash with paltry reimbursement rates. The most recent fee schedule is a complete disaster. From 2011 to 2021, Medicare physician pay rose a measly 11%, failing to keep pace with inflation. This unsustainable situation has forced many independent practices into the arms of large health systems. The proof? The share of physicians in private practice plummeted from 61.8% in 2012 to just 30.2% by 2020.

But that's not all.

The government has systematically tilted the playing field against physician-owned hospitals. The Affordable Care Act effectively banned new physician-owned hospitals and stifled the growth of existing ones. This protectionist policy, devised by democrat party leadership, benefited corporate health systems at the expense of entrepreneurial doctors seeking to provide high-quality, cost-efficient care.

Let's not forget about the caps on residency positions, which have been in place since the Balanced Budget Act of 1997. By artificially limiting the supply of physicians, these caps have contributed to physician shortages and reduced competition. This strengthened large health systems' negotiating power over doctors and insurers.

Speaking of insurers, they've been laughing all the way to the bank. See the equity chart for evidence. By giving preferential treatment to large health systems, they've accelerated consolidation. This has allowed insurers to suppress reimbursements for independent physicians.

Case in point: primary care doctors in private practice earned 21% less than their employed counterparts in 2020. Private equity firms have feasted on this dysfunction, snatching up physician practices left and right.

PE deals involving physician practices more than doubled between 2013 and 2016. PE has a fiduciary obligation to its investment, so it often imposes draconian cost-cutting measures that erode physician autonomy and patient care. The result? Practices acquired by PE saw an eye-popping 70% increase in Medicare billing and a 23% increase in patient volume.

As if that weren't enough, laws like the No Surprises Act have further empowered insurers. The Act's arbitration process has been skewed toward the payers, allowing them to lowball reimbursements for out-of-network care. This puts even more financial pressure on independent physicians.

Over 70% of physicians are beholden to hospitals, health systems, or corporate overlords. The fee-for-service model reigns supreme in the MBUCAs (Medicare, Blue Cross, United, Cigna, Aetna). Meanwhile, per-capita healthcare spending has more than doubled from 2000 to 2020. Yet physicians' slice of the pie keeps shrinking – from 8.6% of total healthcare spending in 2002 to a paltry 4.5% in 2016.

Enough is enough. It's time to fight back against the government forces that have legislated control over the practice of medicine. Unite with your fellow independent physicians to demand fair reimbursement, less red tape, and a level playing field. Your patients and the future of medicine depend on your willingness to resist the corporate takeover of healthcare.

You've been getting screwed for too long. Now is the moment to take a stand and reclaim your independence.

Sincerely,

Dutch Rojas