This week I got a message from a physician who is a member of a health system’s employed medical group. He’d come across my quote in a story that aired on Charlotte, NC’s NPR affiliate WFAE discussing the recent exits of large groups of doctors from two health system-sponsored medical groups in that market. When we connected over the phone, he said, “Splitting off from the health system is something that doctors joke about over beers. Is this for real, and how were they able to do it? Where else is this happening?”
From our perspective, the situation in Charlotte is unique—we haven’t seen another market where dozens of doctors have “seceded” from an employed group en masse to return to independent practice. But we wouldn’t be surprised to see others. A general sense of practice fatigue has made some doctors antsy, and more open to exploring other options. And it’s hard for employed doctors to ignore the big dollars being commanded by large, independent physician practices from payers and investors.
Given the depth of integration and shared infrastructure, exiting an employment arrangement today is far more complex compared to twenty years ago, when it was almost as easy as changing the sign on the practice door. But doctors in many markets are watching the fate of their newly-independent peers in Charlotte. Health systems whose medical groups lack an integrated identity, shared values and common culture may be the most susceptible to a possible wave of physician secession.