Why Private Practitioners Are Still the Best Choice for Consumers

A private practice is your best bet for receiving the highest quality of care at the lowest cost.
By Nicholas Grosso, M.D., Contributor

It's true that private physician practices are not as common as they once were. But don't write them off just yet: A private practice is still your best bet for receiving the highest quality of care at the lowest cost. And although the number of private practices has declined significantly in recent years, they are poised for a comeback under a new business model.
Here's what that means for consumers – and why you shouldn't give up on private practices:
Independence leads to the best care. Under the private practice model, physicians have full autonomy to make the decisions that will lead to the best outcome for the patient. The trusted doctor-patient relationship is comprised of just two parties: the physician and the patient.
A third party is often introduced to this relationship when physicians work for large hospitals or health systems. These health systems, primarily led by executives with no clinical training, have a surprising amount of influence in the medical decisions a physician is allowed to make. The organization might dictate what tests to perform, which brand of implants to use in orthopaedic surgery and even push for more surgeries regardless of whether they are truly required by the patient. As an orthopaedic surgeon who has spent much of my career serving patients at my own private practice, I have always valued the autonomy I have to make referrals to the best specialists, prioritize non-invasive treatment options and squeeze patients into my schedule for emergency visits. With this model, I have the latitude to make sure that every single treatment decision is based on evidence, best practices and the patient's health history.
Additionally, independent practices are much more nimble than large health systems or hospitals – which means that we can adopt new technology and techniques more quickly.
[See: HIPAA: Protecting Your Health Information.]
Private practice treatment can drive down expenses. Hospital treatment will always be the most expensive option for a variety of reasons, including site of service fees and reimbursement structures. Whenever possible, private practitioners can perform surgeries for low-risk patients in outpatient centers – which dramatically lowers costs while typically improving the patient experience.
A recent study published in Orthopaedic Reviews found that orthopaedic surgeries cost an average of $3,225 more when performed in a hospital setting compared to an outpatient clinic. And that's just the average – the research found that cost savings ranged from 17.6 percent to 57.6 percent. Another study found that ACL reconstruction surgery cost an average of $9,220 at an inpatient hospital facility and just $3,905 in an outpatient clinic. But the quality is not poorer because of the lower cost: Additional research has shown that outpatient care is simply more efficient, allowing patients to spend 25 percent less time in the ambulatory surgical center than they would in a hospital setting, while realizing the same clinical outcomes.
[See: 14 Things You Didn't Know About Nurses.]
The private practice model is evolving – not dying. The independent "super group" is a new business model that is rapidly gaining traction because it combines the best of both worlds. When individual practices join together, they can maintain the autonomy and standard of patient care that is unique to private practices – while also benefiting from shared financial resources, economies of scale and a broader network of services. My group, The Centers for Advanced Orthopaedics, was among the first to pilot this model, and today we are the largest private provider of orthopaedic care in the country and have more than 30 individual practices on board.
Our commitment to quality, the patient experience and efficient, low-cost services remains the same. But with the backing of a larger group, we can offer patients convenient access to local specialists, plus ancillary services like physical therapy. We also have the industry recognition to move forward with value-based care payment models, such as bundled payments.
Super groups are becoming an increasingly compelling and viable option for private practitioners of every specialty, from primary care to urology. If a super group doesn't already exist in your area, you will likely have one soon.
[See: 10 Questions Doctors Wish Their Patients Would Ask.]
So the next time you need to search for a medical professional, don't skip past the private practices and assume they won't be in business much longer. Instead, think about the independent care and cost savings they can provide, and make the decision based on your own circumstances. The private practice model, although it has certainly struggled in recent years, is here to stay.
Dr. Nicholas Grosso is president of The Centers for Advanced Orthopaedics.
Tags: patients, patient advice, health care, doctors

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