> why doesn't this happen to restaurants, or super markets or car mechanics
They get bought out by PEs as well.
> The other problem is the regulation and groups like AMA
My SO is a Doctor, and most of her overhead is from paperwork, billing, and IT.
Managing a HRM, your clinic's IT, your clinic's medical devices, your clinic's digitized patient records, the paper trail needed to get paid, etc is hard.
Most older practitioners have sold their clinics to PEs for that reason - they don't want to spend an additional 20-30 hours a week dealing with the issues above.
This is why they sell off their practices to consolidated groups, because they will unify these services but give the Doctor a paycheck.
I don't think PE is the problem here. We love to hear the negative stories but there are also lots of success stories.
From the healthcare industry, I believe the primary care model is broken. There is a nationwide shortage of primary care doctors, usually the ones wanting to get in primary care enjoy the touch on patients. The problem is what you outlined, to run a primary care practice you need to employ a number of people that creates overhead that now requires you to be very rigid in the practice to ensure you can both cover your expenses and still make a salary yourself.
The shortage of PCPs is a money problem, not a symptom of a broken model.
People smart enough to go to med school are (generally) also smart enough to do an ROI analysis. If I can make $500k/yr as an oncologist and pay off my student loans in 10 years vs. getting paid $150k/yr as a PCP and pay off my student loans in 30 years, which route am I going to choose? People that want to be PCPs are making the choice to go into higher-paying specialties just because it is expensive to become a doctor in the first place.
Obviously it is possible to change the economic incentives to increase the supply of PCPs. One simple way would be to just create full-ride scholarships for those that want to be PCPs to dramatically increase the ROI for being a PCP.
I don't believe its entirely a money problem. Certainly there is a factor but that oncologist is also spending a few more years in Residency typically. The trade-off is that as a PCP you are working predictable hours in generally a low stress environment.
So I agree money is a factor but I also think the current insurance model makes its incredible difficult to run a PC office. You have to bring on significant overhead which you then need to cover my making strict quotas on seeing patients. I don't believe this aligns with what PCP enjoy doing.
>My SO is a Doctor, and most of her overhead is from paperwork, billing, and IT.
We own a clinic too.
You either are lying because labor is over 60% of the overhead, or you don't have labor.
Anyway, there is not much to complain about. We can be terrible business owners and overhire, and we still are profitable. The margins are insane on private healthcare and breakeven on medicaid.
The losers are patients, especially private paid patients. Medicaid patients often end up with significantly more treatment since its free.
They get bought out by PEs as well.
> The other problem is the regulation and groups like AMA
My SO is a Doctor, and most of her overhead is from paperwork, billing, and IT.
Managing a HRM, your clinic's IT, your clinic's medical devices, your clinic's digitized patient records, the paper trail needed to get paid, etc is hard.
Most older practitioners have sold their clinics to PEs for that reason - they don't want to spend an additional 20-30 hours a week dealing with the issues above.
This is why they sell off their practices to consolidated groups, because they will unify these services but give the Doctor a paycheck.