Many Ark docs moving from solo to group practices

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LITTLE ROCK (KATV) – It’s a trend you might have noticed when making an appointment with your doctor – more and more doctors are moving from solo practices to group practices.

Channel 7 reached out to doctors and experts to find out how the change affects patients.

Dr. J. Timothy Hodges is one of six doctors at Barg-Gray Family Clinic in Little Rock.

After more than 30 years in private practice, last November Hodges decided he was done.

“I was one of the last guys to hold out,” Hodges said with a chuckle.

“25, 35 years ago maybe, 65 percent of physicians were probably in solo or very small group practices. That’s flip flopped,” explained David Wroten, the executive vice president of the Arkansas Medical Society.

Wroten said there aren’t any exact statistics or studies done on the number of doctors closing their private practice to join a group or hospital, but added there should be because it’s a trend that’s exploding.

“What we’ve seen in the last five years, particularly with the increased level of regulations, now we’ve got physicians have to deal with Medicare regulations, Medicaid regulations, the private insurance company rules and regulations, requirements that care be prior-authorized by a carrier,” Wroten explained. “All of these barriers that have been placed up between the doctor and their patient that had had a significant impact.”

“The reason for me was because of the changes that had come through EMR,” Hodges said.

EMR stands for electronic medical records, a digital way of storing, organizing and sharing medical records.

It’s part of a 2009 program put in place by the federal government that provides either incentives for using the system, or penalties for not.

“We used to do fine with a pencil and some paper,” Hodges laughed. “But no, those days are past.”

Everywhere you look in medical offices today, doctors and staff are on computers.

Hodges said, for him, the technology was too much, adding hours to his already-heavy workload.

“EMR has a tendency to add somewhere between two and three hours a day to whatever you’re doing,” Hodges estimated.

For others, especially new physicians, it’s the cost. Wroten said with medical school loans that can reach hundreds of thousands of dollars, many don’t want to take on additional loans to start their own practice.

“You know one or two people by themselves to take an 80 thousand dollar hit to put in electronic medical records, it’s a big deal,” said Dr. Janet Cathey.

Cathey now works for UAMS after being in private practice for 35 years.

Although she left for health reasons after a car accident, she said the changes would have eventually forced her to move to a group.

“The community loses in a lot of ways. And one of the ways you have to realize is physicians, we are small businessmen. I mean, we build offices and we employ people,” Cathey said. “I think you can definitely see it. These professional buildings are emptier. A lot of office space is for lease.”

In fact, although Hodges closed his practice nine months ago, his name is still on the door of his old empty office just down the street from his new group.

So how does this affect the patients?

The doctors we spoke with say a group practice provides access to more services like x-rays and ultrasounds, possibly less wait time to schedule an appointment, and colleague support for your physician.

“I think I’m a better doc because of the ability to bounce off the other docs here,” Hodges offered.

But it also could sacrifice a traditional doctor/patient relationship.

“I can’t look at an electronic medical record and know someone’s story, and put a face and a person with this,” Cathey said. “Standardized, everybody sounds the same.”

Cathey said the future appears to be group practice, and patients and doctors are making the best of it.

“It’s just such a change in medicine,” Cathey said. We can look at that single thing and say this changed medicine. And not necessarily better, not necessarily worse, but it just made it different.