Healthcare needs Physician Independence

10 min read

The single fundamental factor that unravels the medical profession from the tread is its deep root in intimate human life. It is a liturgy, pertaining directly to a person’s life. It is private and sacred to anyone investigating in such service. To fulfill the task, a doctor must recognize every single one of their patient’s injunctions within their personal space and meet them halfway at the juncture of objectivity and subjective reasoning.

Therefore, to conform to their respective duties, physicians expect substantial flexibility and faith. Founded on that provision, it is similarly plausible, yet aspired to say, to accomplish the duties patient, and the physician must amass independence from 3rd party forces. It is also equitable to state; the intimate collaborative climate of the clinical profession would contemplate as counterproductive to a strategy where the day to day journey of a medical practice exists through consolidative bureaucratic protocols. That is not only valid for the clinical element of the medical practice but also pertains to the logistics, business, and subordination of how a patient interacts with a given physician at a lent point of time and place.

Ultimately, it is fair to reckon that a scalable medical practice infers to an independent one. For example, folks residing in rural towns may have distinct priorities than their peers living in urban neighborhoods.

Having caressed on, despite overwhelming wisdom as to why independent medical practice survival is vital to the underserved population’s sovereignty, yet we glimpse into corporate overtake of medical practices. That- through decades deprived independent physicians out of training, and away from underserved municipalities, yet barely replaced by anything worthwhile.

It is integral to comprehend that independent healthcare stakeholders could maintain the quality and valuable medical service to those with affluent alternatives since equipped to serve as the driver of the shift towards better care.

Further Centralization of the process is hardly the answer

On the contrary, few erroneously Latterare under the presumption that centralizing, using standard protocols, and corporatizing the operations would eventually deliver quality care at a lower cost to the underserved societies such as rural regions by authoritative redistribution of medical aids. But clearly, the recent history has proven otherwise!

In fact, according to a report published in the journal of medical economics, the latest attainable data indicates, 47.4 percent of US physicians functioned as staffers in 2018. Compared to 45.9 percent who were independent practice holders.

According to the American Medical Association (AMA), The prevailing 6.7 percent of physicians in 2018 worked as independent contractors, a shift of 7 percent since 2012. Based on the different reports, the Independent physicians have been showing come back, especially in some midwestern and southern states of the United States. However, despite the over-enthusiasm centered around revitalizing private medical practices, the rural areas still grieving the fallouts of their calamity to corporate medicine.

As an instance, Taylor Walker, a 25-year-old resident of a tiny remote town of Arthur, Nebraska, with her young son, and pregnant, thought back to having horrible pain with her latest pregnancy. She recollected not being able to get to see her doctor, as Visiting her obstetrician in North Platte. Taylor had to make a four-hour, round-trip attempt that meant relinquishing a day of reimbursable work at the local bar and Grill. Often, she remembered arriving at her scheduled visit only to realize that another doctor was on call, and hers wasn’t even available. That necessitated further journeys to get into see her regular doctor.

Taylors particular challenges are not unique to herself, as many in the United States and across the world can utterly relate to her healthcare adventure. Today, Rural Hospitals and clinics are closing at a startling rate with a surge of Ninety-Eight percent in the year 2019. Such a scenario has little or nothing to do with the economic stature of the country or state. Nevertheless, it is utterly disturbing to see mighty dishonor towards rural inhabitants in a progressive country such as the United States. One of the significant challenges is to chase a doctor who appreciates the rural constituency and recognizes the cowboy psyche of their Populous.

Millennials and Healthcare

The doctors of the millennium, frequently fail to comprehend how a cowboy can go that long with pain and not seek doctors’ attention until he desires. There’s an upheaval of guard affecting rural America, also the whole healthcare system. As baby boomer physicians head towards retirement, independent practices are closing down. Only 1% of doctors in their last year of medical school indicate their interest in living in communities under 10,000 population, and only 2% wish to live in towns of 25,000 or fewer.

The National Rural Health Association report suggests the ratio of patients to primary care physicians in rural regions being 39.8 per 100,000, compared to 53.3 per 100,000 in urban neighborhoods. Family physicians, who make up only 15% of the physician workforce nationwide, provide 42% of the care in rural areas. The crisis appears to be reaping to worse for rural areas.

A Perspective article published in May 2019 issue of New England Journal of Medicine discusses the aging of the rural physician community. Accordingly, more than half of rustic doctors are age 50 or older, indicating that retirement will account for an extra 23% plunge of physician pool to those regions by 2030. It postulated that the majority of physicians are inclined to practice where they trained initially, as prevalence tends to work with the hospitals in urban areas associated with their respective medical schools and residency programs.

Revisiting physician duties

A physician, medical practitioner, medical doctor, or merely the doctor is a professional person who practices medicine. He or she is somebody routinely involved with facilitating, preserving, and rebuilding human health and wellbeing through the use of diagnosis, prediction, and therapy of physical, mental disorders, injury, and other agonies.

The Independent Physician is one who owns and thus clenches all or bulk control of his or her profession. Because of soul sovereignty, the autonomous doctor enjoys the latitude of making critical decisions for the practice. Heretofore by nature, the medical profession is a personal endeavor. Hence privilege of coming to be an Independent Physician entails aptitude to exercise medicine by operating a practice self-sufficient outside leverage.

In general, today, physicians’ selection of employment over independent practice is merely reflective of their repudiation or ineptitude to compete with the larger organizations to sustain the lean and productive clinical practice. With the ever-increasing executive injunctions and expanding, overhead expenses retaining independence is a substance of choice between physician Burnout and capitulating to a one-size-fits-all process.

Physicians are independent by trait

As spoken of earlier, Physicians are independent creatures by quality, because that is the milieu where they can deliver quality skilled care to the level of patient satisfaction. Medical practice is intimate to doctors, as are bound by an ethical commitment to every human being. For an authentic physician medical profession is more than a chore. It is a lifestyle with a lifetime allegiance. Healthcare, too, is personal to every patient, as it makes up the most invaluable possession of every human being. Precisely based on the justifications bestowed Patients relate with their doctors; and not a clinic, facility, entity, or service. Keeping Independent practices alive maintains personal significance to its elemental constituency.

There is a relative shortage of physicians in rural areas of America but not nationwide.

Specialization and rural physician supply

A study postulated that the further specialized the physician skills, the less likely he or she would want to settle in a rural region. To the same extent, female doctors indicate a particular preference for the urban style of medical practice. Although managed care systems have recently turned into recruiting physicians to serve in country settings, nonetheless seems like their doctors are of the scarce windfall to the needy working individuals who have neither Medicaid coverage nor conventional health insurance. Therefore, Possible solutions to the dilemma of rural physician scarcities proposed are the modification of the medical education system. Hence, it trains more physicians who would voluntarily choose to practice in a rural setting, while rewriting the reimbursement strategies of Medicare and Medicaid, and evolving the existing federal and state programs.

Health Maintainance organization

According to an article published in the western journal of medicine in 1999- managed care systems play an emerging influence on the delivery of rural health care. nonetheless, their dominant role in rural countries is exceptionally sluggish. In 1995 More than 80% of rural counties were in the service area of at least one health maintenance organization (HMO). Today, the probability of the rural public enrolled in HMOs is said to be less than 8.6%. Managed care is not only a beast of the private sector but nationally, only about a tenth of rural Medicaid recipients participate in Medicaid HMOs and prepaid plans.

HMO is a” 2-edged sword.” As the article puts forward, one accomplished by its geographic distribution, and second failure to address rural medical underserviced. Managed care networks have the potential to provide organizational vehicles for hiring and deploying physicians through arm twisting initiatives in regions that could not support independent physicians on their own. But two potentially unfavorable consequences of managed care systems on rural health entail the loss of provincial control of health care systems and the reticence of privately administered care systems to provide care to the uninsured. Most big municipal institutions underwrite managed care networks, where those forces carry little insight or empathy for deserted rural neighborhoods.

The presence of physicians hired through vertically integrated schemes may mean that the community has health experts. Still, they may be of nominal use to the working impoverished who have neither Medicaid nor conventional health insurance. The managed care industry is showing sudden influx, and the magnitude to which it will eventually dominate rural areas, but if it can succeed as an urban model has, it is hard to foresee. Since the time of its announcement in the western journal of medicine in 1999, rural healthcare has further spun off out of control, where more and more hospitals and clinics had closed their doors in 2019; and continue to do so!

Survival of independent physicians is crucial

Independence of physicians and their practice clears the avenues for healthcare survival, growth, and quality of medical service, not only in the rural areas but also throughout the globe. It is adaptable, intimate, and centered around patients and doctors. It is decentralization by virtue, hence easy to adapt to a given habitat. Large systems are anything but that; henceforth, their predisposition to veer around the Feasibility of business model plays a leading role for close systems like HMO networks.

From the inception of the managed care system, rural communities are lingering more than ever from a shortage of quality medical care. Even their expansion to rural communities is catalyzed by abuse of government grants, which could have further efficiently utilized if focused on empowering the physician and patient grassroots within the needy populations.

Rural areas like any other community, if not more, need physicians who can relate with them. Rural Communities appreciate the value of personal sense and compassionate care when expected, and will support physicians founded on that tenet.

Corporate Take over of healthcare

Corporate for-profit systems will languish to sustain in rural locales in a humanistic posture. For the Corporate systems to sustain themselves, they must decree rigorous protocols. yet then, through access to taxpayers’ money and government backing, while opportunities are taken away from independent physicians. Governments’ mishandling of the subject is further deterring to the medical community, be it through unsubstantiated mandates or promoting haven to corporate extortion medical societies side with the powerful entities.

The corporate takeover of the healthcare industry is transpiring before our sights, where politicians are drawn away to appease constituents’ contentment while information is not conveying the actual portrait through net-neutrality. State and federal legislators anticipate regulating the healthcare system strictly. They anticipate bringing in all healthcare institutions function according to the identical ordinances. It is their peculiar way to govern as inexpensively as feasible. The path they have decided on leads to a system where every physician observes the same protocols, and all patient medical records are centralized. The latter intuitively attends a means to give rise to the sprawling healthcare system that felt manageable and affordable. To do just that, Government has been enabling the managed care system as the promising prototype for effective, affordable healthcare delivery. But while an allocated care system might be best for government officials, it has flunked the patients, more so those living in rural communities.

Amid engaging with the corporate HMO, the administration has been inescapably sought direct negotiations with the same entities. Concomitantly they have created a constitution conflict of interest between citizens’ welfare and corporate profiteering.

Related Article: Can Primary Care sustain Quality Healthcare for All? — A comparative analysis in the context of developed; and developing states 

Governments role

Any government effort, whether direct by way of legislative mandates or indirect through subsidizing corporations, should be averted. Any authoritative constraints must be maintained at high-level and aligned with the kind of principles and focus towards assuring public safety rather than exploiting clinical judgment through the facilitation of managed care corporate medicine.

The expectation should sustain macro-management, rather than micromanaging physician clinical judgment! To avoid corporate favoritism by the Government- accountability, transparency, and voting power should be taken as virtues. To any administration; Corporations may seem efficient and economically attractive in the short run. However, they arrive at the expenditure of independence practices, which are needed to strengthen medical care in underserved districts.

The contrary to what is being conveyed by a few, the problem isn’t necessarily the primary physician shortage. The main challenges are the scarcity of doctors who are willing to give away other urban opportunities and not reprimanded for working extra hours and burnout.

World; the US, in particular, is overlooking a large-scale conspiracy. The insurance industry is putting their nose amidst who works where and how gets reimbursed! The Independent physician practice survival stands critical to the underserved provinces, as it permits them admission to quality medical service and the privilege to stay healthy.

Independent physician practices need to modernize; this time with a new veil

The perception of the rural physician shortage has steered the healthcare initiative to encourage doctors to practice outside of the cosmopolitan districts, like finding ways to make it lucrative for doctors to practice in rustic neighborhoods by hurling money at the crisis. It has also formulated changes to the medical education curriculum, along with executing residency programs in rural medical care settings. In this way, physicians thought to gain both the competence and confidence to thrive in a rural environment, making it much more likely that they’ll remain in the area after they complete their programs.

Concept of Diversification of clinical Curriculum

The concept of diversifying curriculum to support rural communities is a great one. Nevertheless, it appears over-optimistic to infer; while rural hospitals are forcefully shut their doors, contemplating to open a residency program in those regions is a matter of impracticality, as Residency programs require significant financing and optimal resources. Lack of independent fiscal reserves alongside insufficient volume and diversity of medical cases is exactly why rural healthcare is suffering today. Current system does not furnish sufficient patient caseload for a residency program to instruct their candidates.

An entirely modern system of practice management is expected to equip decent healthcare outside of urban locales, a scenario that lends small clinics access to the same knack and technological boosts that are available to bigger networks.

As the world goes digital, clinics in non-urban areas need to be immersed with one another, to government administrations and more extensive health systems. They require the ability to simplify processes and slash expenses without hiring additional consultants and other staff members. Something which, if upheld would further strain the original appropriation.

Steps towards sustaining rural healthcare

Steps towards achieving rural healthcare are multifaceted and must be pertained at the grassroots. Because rural neighborhoods retain a unique perspective of health and healthcare; therefore, it is essential to centralized health information and the system altogether.

The ideal operations of the sovereign community are best enacted through the collaborative undertaking of that society within and other regions. Meanwhile, it would subsist as the obligation of the administration to endure high level, transparent yet precise accountability to dissuade economic rent.

The significant obstacles of government omission in establishing quality medical services for underserved provinces are its top-down policies. They have historically engaged in providing safe-haven to pure business oriented one-size-fits-all corporate medicine. That is partly fueled by licensing and certification monopoly; henceforth, the Government is the only and the ultimate agent that can assure such ordinance. It can potentially stimulate the individual elements of social talents, economy, and health. Establishing and Optimizing the virtual open healthcare marketplace is also in the strategies that would potentially stimulate the economy and enhance support.

There is a need for free Healthcare Marketplace

Citizens need a free and open healthcare market, one excited by modern technologies, thus able to bring patients, physicians, and the stakeholders together without impediments.

Optimizing telehealth is meaningful but not sufficient to meet the patient’s expectations and physicians’ needs. The modern system must concentrate on building a variety of healthcare technology and services. Those that will concomitantly generate job opportunities; and incentivize the rural population to contribute to their own demands and decision making. That makes the significance of Empowering the individuality of constituency even more meaningful.


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Adam Tabriz, MD Dr. Adam Tabriz is an Executive level physician, writer, personalized healthcare system advocate, and entrepreneur with 15+ years of success performing surgery, treating patients, and creating innovative solutions for independent healthcare providers. He provides critically needed remote care access to underserved populations in the Healthcare Beyond Borders initiative. His mission is to create a highly effective business model that alleviates the economic and legislative burden of independent practitioners, empowers patients, and creates ease of access to medical services for everyone. He believes in Achieving performance excellence by leveraging medical expertise and modern-day technology.

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