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Forbes
5 days ago
- Business
- Forbes
As Trump Cuts Healthcare, Private Equity Gains Hold At Doctor's Office
Just two in five U.S. physicians are in doctor-owned private practice as hospitals and private equity firms gobble up physician groups thanks in part to cuts in insurance payments to medical care providers that are about to get even worse. The American Medical Association, the nation's largest physician group, says in a new report that the share of physicians working in private practice was 42.2% last year, which is a sharp decline from more than a decade ago when more than 60% -- or three in five doctors – were in private practice, which the AMA defines as a 'practice wholly owned by physicians.' The AMA's analysis blames flat to falling payments from health insurance companies and government health programs like Medicare coverage for the elderly and Medicaid coverage for low-income Americans among the reasons physicians are selling to hospitals, health systems and private equity. In addition, AMA says its data cites 'costly resources, and burdensome regulatory and administrative requirements' as 'longstanding and important drivers of this change.' 'The share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures,' said AMA President Dr. Bruce A. Scott said. 'The cumulative impact of burdensome regulations, rising financial strain, and relentless cuts in payment poses a dire threat to the sustainability of private practices," Scott said. "After adjusting for inflation in practice costs, Medicare physician payment has fallen 33 percent over the past quarter century, which has severely destabilized private practices and jeopardized patients' access to care. Payment updates are necessary for physicians to continue to practice independently.' But there appears to be little interest by the Republican-controlled Congress to boost payments to physicians. The AMA report comes as Republicans in Congress and the Donald Trump White push for more cuts in federal health insurance programs, including Medicaid and Medicare, which would most certainly spill over onto doctor practices as more Americans lose health insurance. Last week, a new analysis published by the Robert Wood Johnson Foundation of the budget reconciliation bill passed by the U.S. House of Representatives shows physicians and other healthcare providers 'could lose more than $770 billion in revenue over the next decade as a result of more than 11 million people losing health coverage through Medicaid and the Affordable Care Act marketplaces.' The budget still faces approval by the U.S. Senate and would need to be signed into law by Trump. Meanwhile, more and more physicians are working for hospitals or companies owned by private equity no matter their medical discipline. 'Private practices now account for less than half of physicians in most medical specialties, ranging from 30.7 percent in cardiology to 46.9 percent in radiology,' the AMA said of its report. 'Exceptions included orthopedic surgery (54 percent), ophthalmology (70.4 percent), and other surgical subspecialties (51.2 percent).' The share of physicians working in hospital-owned practices increased to more than one-third, or 34.5 percent last year. 'Twelve percent of physicians were employed directly by a hospital (or contracted directly with a hospital), double the share (5.6 percent) in 2012,' the AMA said. 'In 2024, 6.5 percent of physicians characterized their practice as private equity-owned, higher than the shares in 2020 and 2022, which were both around 4.5 percent, the report noted.'
Axios
09-03-2025
- Health
- Axios
Doctors are still burned out five years after COVID exposed systemic failures
Five years after COVID shook the world, doctors and other health providers continue to suffer from burnout that the pandemic highlighted and exacerbated. Why it matters: Provider burnout — an ongoing state of significant stress — takes a toll on patients, too. A pre-COVID study found burnout costs the health system about $4.6 billion a year due to physicians leaving the field or cutting back on hours. Another study linked doctor burnout with a doubled risk for patient safety issues. The big picture: There's been significant progress to reduce the stigma around doctors seeking mental health treatment since the pandemic, but physicians say systemic change to payment and administrative workloads are needed to really improve their wellbeing. "We need to address the root causes of the problem, all the failures in our health care system right now that are causing challenges for physicians," American Medical Association President Bruce Scott told Axios. Where it stands: Nearly half of physicians (48%) say they feel burned out, according to the AMA's most recent poll, published in July. Women physicians face higher levels of burnout and risk of suicide than their male counterparts. The overall burnout rate is down from 2021's high of 63%, when the Delta coronavirusvariant raged. Still, "the fact that one in two physicians in America are showing signs of burnout is an unacceptable number," Scott told Axios. Burnout among nurses and other health providers also worsened during the pandemic. Flashback: Providers' poor mental health and burnout has been a problem for years. The pandemic supercharged it, as doctors, nurses and other medical providers worked long hours with less equipment and often in isolation to save the first COVID-19 patients. Health providers were lauded as heroes at the start of the pandemic, and some even reported improved wellbeing at work, citing more time spent with patients and less spent on paperwork. But that didn't last. "Five minutes later, it felt like those same workers were being questioned about the science, getting spit on, threatened," said Corey Feist, CEO of the Dr. Lorna Breen Heroes' Foundation. Feist started the advocacy group in memory of his sister-in-law, an emergency room physician who took her own life in 2020. State of play: There's growing awareness of the stresses on health providers. More than half of states and hundreds of individual hospitals have now changed their licensure requirements to remove questions that ask whether a doctor has received mental health treatment or diagnoses. Those questions have historically deterred doctors from seeking needed help. The Dr. Lorna Breen Heroes' Foundation coordinates learning collaboratives for hospitals and medical groups to work together on implementing operational changes that support provider wellbeing. Congress also passed a law in 2022 that opened federal grants for training health providers on strategies to reduce and prevent burnout and other issues. The funding authorizations expired last year, but lawmakers have introduced a bipartisan bill to extend them. Yes, but: Real improvement requires tackling structural issues, like decreasing Medicare payment rates that make it harder to operate a practice and rising administrative burden associated with insurance claims, doctors and experts say. Zoom in: The primary driver of health care provider burnout is too much work for too few people, said Srijan Sen, a psychiatrist who researches physician well-being at the University of Michigan. "Increasing the number of people working, and, even more long term, helping people stay healthier, so less people need health care — those sorts of things will be a big part of the solution," he said. What to watch: Scores of health tech companies now advertise tools, often driven by artificial intelligence, aimed at cutting down provider workload by automating administrative tasks. It's not yet clear if they'll deliver, Sen said. The electronic health record once promised to make a physician's job easier, and research now shows it has directly contributed to increased burnout. Despite the stressors and predicted workforce shortages, health care still is projected to add the most jobs in the U.S. of any sector over the next decade, and medical schools are seeing more interest than ever. Today's students are more attuned to their mental health than in the past, and they're asking what can be done to make the field one they want to continue working in, said Kelly Holder, chief well-being officer at Brown University's medical school.
Miami Herald
06-03-2025
- Health
- Miami Herald
Where are measles cases popping up around the country? Take a look at this map
A growing measles outbreak in the country is raising concern among heath experts who worry that not enough people are getting vaccinated against a highly contagious disease that was considered to be eliminated in the U.S. 'In Texas and a growing number of states across the country, declining vaccination rates are fueling a staggering increase in measles illnesses, measles hospitalizations, and the first death from the disease in years — all primarily among unvaccinated populations,' American Medical Association President Dr. Bruce Scott said in a statement. The U.S. has recorded more than 160 cases of measles in early 2025. That's already over half the total number of cases the country recorded for all of 2024, according to data from the U.S. Centers for Disease Control and Prevention. Measles is a highly contagious disease that spreads easily and produces a rash that typically covers a person's body, along with cold and flu-like symptoms, including a high fever up to 105 degrees. While most people can recover at home, the disease can lead to serious complications, including pneumonia and brain swelling, hospitalization and death. Most of the measles cases reported so far this year are in Texas, where health officials are trying to clamp down on a growing outbreak that has sickened more than 150 people. Other states have also recorded measles cases though they trail far behind Texas, including New Mexico, California and New York City. Florida recently confirmed its first measles case this year in Miami-Dade County. READ MORE: Are you at risk for measles? Miami sees case amid U.S. outbreak. What to know in Florida Here's a measles case breakdown by state for 2025: How to reduce measles risk Public health experts say the best protection against measles is to get vaccinated with the measles, mumps and rubella vaccine, or MMR, which is considered highly effective in preventing infection. It helped the U.S. eliminate the disease in 2000. This means that while outbreaks sometimes happen, it's usually because an unvaccinated traveler fell ill in another country and came into the U.S., spreading the virus to other unvaccinated people. But doctors and health experts the Herald has spoken with have indicated concern over recent cases of the disease and how Florida, like the rest of the U.S., has seen an overall decline in children vaccinations since the COVID pandemic. While states usually require students to get the MMR vaccine and other shots to attend school, there's been a rise in exemptions, according to KFF, a nonprofit, nonpartisan organization that provides information and research on health issues and policies. 'Vaccination not only prevents infection, measles-related complications and even death, but also helps prevent further spread to loved ones, neighbors, co-workers and others in close contact,' said Scott. 'When immunization rates are high, people who cannot be protected directly by vaccines are protected because they are not exposed to the disease.' One dose of the measles, mumps and rubella vaccine, or MMR, is about 93% effective, with two doses about 97% effective, according to the CDC. Once you get the two-dose vaccination, you're protected for life, experts say. How do U.S. measles cases compare to last year? The U.S. recorded 285 measles cases in 2024. Minnesota recorded the most number of cases in 2024, with 69 cases, followed by Illinois, with 67 cases, and Oregon, with 31 cases, CDC data shows. Florida had the sixth highest number of recorded cases in the country, with 13. Here's a 2024 measles case breakdown by state: Where can you get measles vaccine? Kids should get the first dose at 12 through 15 months of age and the second dose at 4 to 6 years of age. About 3 of 100 people vaccinated with two doses will fall ill if exposed to the virus, the CDC says. MMR vaccines are usually available at doctor offices, pharmacies, clinics and community health centers. Speak with your doctor if you have questions about the shot or are unsure whether you and your child have already received it.
