Many physicians have become apprehensive given the current state of the healthcare system in this country. Instead of remaining independent, many doctors are changing to salaried positions with hospitals.  Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years. Almost 60 percent of family doctors and pediatricians, 50 percent of surgeons, and 25 percent of surgical subspecialties are now employed by hospitals.

Many doctors are either giving up their practices to work in hospital buildings, or allowing their practices to be purchased by hospitals, becoming part of the hospital referral network.  Medical  malpractice insurance premiums are rising, and new requirements to provide health insurance to practice employees are contributing to the increasing costs to operate an independent practice.  It is cheaper and more secure to work as part of a hospital system.

There is ongoing debate about the effects of these shifts to salaried positions. Many advocates argue that having most medical services under a hospital umbrella allows for more cost-effective operations and better patient care.  Being able to share information and services enables doctors to be more effective and coordinated in their treatments.  Opponents, however, argue that the shift will do nothing to improve patient care in the long term, and will dramatically increase prices in the short term.  While individual check-ups used to be relatively inexpensive when at an independent practice, a hefty hospital facility fee is now tacked on to every bill.

Read this New York Times Article for more information.