Published December 29, 2021
Since the start of the Covid-19 pandemic, my dad’s rheumatology practice has been flooded with new patients, including many from far-flung cities or out of state. This isn’t thanks to a new marketing strategy or to a notable spike in arthritis sufferers. One elderly woman who had traveled from New Jersey to my father’s Brooklyn, N.Y., office explained that many practices near her home had closed. Those that remained open were so overwhelmed that she would have had to wait eight months for an appointment.
This shouldn’t be surprising. According to a 2020 survey by the Physicians Foundation, 12% of all U.S. doctors either closed their offices during the pandemic or were planning to do so within the year. Some 59% agreed that the pandemic would “lead to a reduction in the number of independent physician practices in their communities,” and half agreed that “hospitals will exert stronger influence over the organization and delivery of healthcare as a result” of the pandemic.
But the pandemic merely accelerated a decadeslong trend. In 1983, more than 75% of physicians owned their own practices, according to American Medical Association physician surveys. By 2018 that figure had dropped to 46%. Many practices have been purchased by hospitals or have merged to form larger clinics, while local hospitals have been subsumed into large health systems. Consolidation is the trend. An AMA report earlier this year found that for the first time, less than half of doctors work in private practices. This is a problem for patients like those who went in search of my father—there are simply fewer places to seek care, and many of those that are available are bureaucratic mega-facilities.
Ms. Goldman is a visiting fellow at the Ethics and Public Policy Center and a senior editor at Mosaic magazine.
Devorah Goldman is EPPC’s Tikvah Visiting Fellow. Her work focuses primarily on medical policy, culture, and public bioethics.