Several doctors across the country are citing that the cost of medical records, the business operations are getting to be expensive as a private practice.  In the news several doctors have been interviewed of late and have stated this is a growing concern if the practice can withstand the transition.  Electronic medical records do come in all sizes and prices and there are subscription models that are affordable.  The days of purchasing a system for an installation on a local based server seem to be slowing down for a couple of reasons, expense and maintenance. 

As everything has moved to the web there simply is not room for a small practice to keep up with the constantly changing world and system updates.  Meaningful Use and attestation does help and depending on which system is selected, cost is covered.  Getting in the stimulus game early is definitely a plus.   New EHR users are required to meet the first stage of meaningful use rules for two years before moving on to the second stage, which contains more core requirements and stricter guidelines and MDs reported achieving meaningful use in 2011 won’t need to move onto the next stage until 2014 which is the same year the 2% penalty starts.

The number of private practice doctors in the US has dropped as in 2000 57% of the nation’s doctors were private practices compared to today where only 39% continue to operate a practice.  Granted things have changed a lot in technology and the type of medical care given.  Back in 2000 the job of a hospitalist didn’t exist so there’s one example that is growing with more hospitals hiring them, and also attracts MDs to closing or selling their private practices.

“Accenture states that its survey indicates that “business operations are one of the main reasons why 61 percent of physicians have decided to seek employment, with cost and expense of running a business indicated as the chief concern for 87 percent of those independent doctors surveyed.”  Furthermore, the cost and hassle involved in installing and operating EHR systems is given by 53 percent of doctors surveyed as a main reason for giving up their private practice.

The Accenture report indicated that doctors who wish to stay in private practice should look to increasing their revenue and reducing their costs by turning to subscription-based models like that offered by Multnomah Family Care Center, a Patient/ Physician Cooperative in Portland, Oregon, where “patients pay a one-time enrollment fee to join, and then pay monthly membership and primary care provider fees, which combined average less than $60 a month.” Patients there use their health insurance to pay for “acute conditions or emergencies,” but otherwise, patients pay the doctor directly for their medical care, thereby bypassing many of the limits on payments imposed by insurance companies or the Federal government.”