IMA Senior Fellow Dr. Mollie James joined The National News Desk to explain why more physicians are leaving hospital systems and insurance networks to practice independently. She cites the clerical work being pushed onto highly trained doctors, micromanagement from health care administrators, and falling incomes, but says it’s mostly about the ability to care for patients the way doctors see fit.
For patients, Dr. James explains, going independent takes the employer and the insurer out of the relationship, leaving only a doctor and a patient. In her view, insurance feeds people into seven-minute visits that lead to more prescriptions, referrals, and tests. An hour with an independent doctor, she argues, can get to the root cause and often costs less in the end. She also calls for more independent imaging centers and specialists, warning that hospitals are starting to build regional monopolies that limit patient choice.
Check out these related resources from IMA below, followed by the full segment transcript.
Transcript
Angela Brown: Democrats are getting ready to take control of Congress, and a growing number of Democratic socialists are pushing for Medicare for All, a government-funded health care system that could cost taxpayers trillions. Critics warn the plan could also put more pressure on doctors and limit patient care, as some physicians are already leaving traditional hospitals and insurance networks to practice on their own independently. Joining us now to discuss all this, what this means for patients, a Senior Fellow with the Independent Medical Alliance, Dr. Mollie James. Thank you so much for being with us, Mollie.
Dr. Mollie James: Good morning, Angela.
Angela Brown: Dr. James, with the debate over government-run health care really heating up again, more doctors are looking into practice outside the traditional hospital and also the traditional insurance system. What is driving this decision, first of all? Why are so many people going independent?
Dr. Mollie James: There’s four main reasons for that. The first is that a lot of administrative burden is being pushed to physicians. So think about it: they’ve done four years of college, four years of medical school, three to seven years of residency, and they’re treated like clerical workers. We’re pushing all of these administrative clicks and burdens and “fill out this paperwork” instead of doing the professional task that they’re meant to do, which is serve their patients.
They’re also being micromanaged by health care administrators: when they can take a day off or cut their hours short a little bit. And they’re just fed up. One of the last reasons is actually incomes are dropping, but it’s mostly about the ability to take care of their patients the way they want.
Angela Brown: And that’s what we all want to know, actually. How is it going to impact the patients? For patients who are used to going through a hospital or insurance network, what actual changes could we see if a doctor goes independent, so to speak?
Dr. Mollie James: So if you are seeing a doctor in a system, and there are some wonderful doctors that are still in that model, their decisions and their recommendations to you get filtered through their actual employer, which is their employer and the insurance. So when you go to an independent doctor, there’s only a doctor and a patient. And so they can give you, the patient, the very best advice, because there’s nobody in the middle of that relationship calling the shots.
And I know there’s even good physicians who have given their patients direct information, and if the system doesn’t agree with it, they get rid of the doctor. So it takes all of that out of the picture.
Angela Brown: But people get comfortable going where they go. What about the perks of it in terms of being tied to a hospital? There could be technology and resources. How do you fill in that gap?
Dr. Mollie James: Yeah, that’s an issue. I really think to solve this problem, we need more and more entities going independent: imaging centers, specialists. Just get the technology out of the hospitals, because they are starting to build monopolies in certain regions. I just had a letter yesterday: a doctor wouldn’t see my patient because the referral didn’t come within the system. So the only way to break that system and give patients choice is to have a decentralized system and have more independent doctors.
Angela Brown: Something like that almost happened to me with the referral, so I hear you on that one. And of course, cost is a big concern. If someone is already paying hundreds of dollars a month for health insurance, why would they want to pay even more, in some cases, to see an independent doctor? What is the cost here? How does that all factor in?
Dr. Mollie James: Yeah, you’re right. Americans are finding out they’re paying $12,000 to $25,000 a year just to hold an insurance card, and then they think that’s going to get them better prices or unlimited services, but it doesn’t. What it does is feeds them into a system where the product is a seven-minute visit.
And so if you don’t have time to dig into the patient’s issues and get to know them, how could you possibly be efficient with their care? So they get more prescriptions, more referrals, more testing, where if I can sit with the patient for 60 minutes, we can sort through a lot of that. And we may need some testing, but we can solve the problem in asking questions, getting to know the patient better.
Angela Brown: Do you have any idea how big this is in terms of doctors going independent? Are we talking about 10%, 20%? Is this a large number you’re seeing? And how big could it get down the road, years to come?
Dr. Mollie James: I think it’s a starting trend. And our friends in direct primary care really put this in vogue, starting about 10, 15 years ago. And it is escalating because doctors are getting fed up.
We are not treated like the professionals that we are. Think about attorneys and CPAs, accountants, other people who have professional degrees. They go out and practice, and they have accountability to their clients. And with physicians, you’re treated like a widget in a machine when you work for a health care system. And people are reaching the breaking point of that.
So when you do go to an independent doc, a lot of times it can be cheaper, even though it’s more money out of pocket, because it’s going to solve the problem at the root cause without all those consults and testing.
Angela Brown: Well, we will all be watching, because this hits home for so many Americans. Thank you so much, Dr. Mollie James, Independent Medical Alliance. Thanks for joining us.
Dr. Mollie James: Thanks, Angela.
