News outlets report on trends in physician employment. The Palm Beach Post
, on the growth of concierge medicine: "As health reform prepares to send another 32 million people into the already stressed health system, some say that concierge medicine is the future — where the wealthy see the best primary care doctors in a luxury setting, and everyone else makes do with clinics staffed by 'physician extenders' such as nurse practitioners. ... More than 430 MDVIP [a concierge medicine company] doctors now practice in 31 states, seeing 138,000 patients. The growth, nearing 25 percent a year, persuaded Procter & Gamble to become 100 percent owner of MDVIP in December. Meanwhile, its concept has been copied, and some observers put the number of concierge doctors nationwide at 5,000" (Singer, 11/7). The Wall Street Journal
: More physicians are choosing to work for hospitals rather than going into private practice. "The latest sign of the continued shift comes from a large Medical Group Management Association survey, which found that the share of responding practices that were hospital-owned last year hit 55%, up from 50% in 2008 and around 30% five years earlier. … The trend is tied to the needs of both doctors and hospitals, as well as to emerging changes in how insurers and government programs pay for care. Many doctors have become frustrated with the duties involved in practice ownership, including wrangling with insurers, dunning patients for their out-of-pocket fees and acquiring new technology." Meanwhile, "[h]ospitals are also seeking to position themselves for new methods of payment, including an emerging model known as accountable-care organizations that is encouraged by the new federal health care law" (Mathews, 11/8).