I can't help but think about my first images of medicine - those provided by TV shows. Last week offered us a view into the world of hospital medicine extending contrived, political and hypersexualized view shown in ABC's Grey's Anatomy and priming us for a conversation on Grey's spinoff, Private Practice. This parallel is at once unbelievably corny and disturbingly insightful.
Where Addision Montgomery left the fictional Seattle Grace Hospital for the quieter, better compensated private clinic, today's trends show a migration in the opposite direction - from independent practice to salaried positions in large institutions. In fact, female physicians are more likely than their male counterparts to work in private practice, often for the benefits of fewer hours at work and on call.
Citing rising costs and stagnant reimbursement rates, many physicians are looking to large practices and institutions for security and salaries. Such organizations have the financial capability to invest in cutting-edge equipment and improvements such as Electronic Medical Records (EMR), and the bargaining pwer to garner the best reimbursement rates from insurance companies.
The future of private practice seems uncertain for both patients and physicians. While an article from the New England Journal of Medicine (The Independent Physician: Going, Going...) cites that 9 out of 10 Americans receive care from such providers, new regulations and reimbursement structures, such as Managed Care, make the proverbial dream of house calls, black bags, and the local GP a thing of the past.
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