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Almost 60% of doctors who worked for hospitals or other corporate entities said patient care suffered when physicians didn't own the business, according to a .

Only 18% of physicians said corporate ownership made patient care better, according to the survey, which was commissioned by the Physicians Advocacy Institute (PAI) and conducted by NORC at the University of Chicago.

"With corporate ownership comes a higher emphasis on financial outcomes and shareholder returns," Kelly Kenney, JD, CEO of PAI, . "This focus on the bottom line can interfere with best clinical practices."

For more than a decade, "there has been a sustained trend of physicians leaving private practice for employment by corporate-owned practices, often affiliated with hospitals, health systems, health insurers, and private equity firms," according to the report. PAI conducted the poll to "gain insights into the implications of this trend on care delivery, clinical decision-making, physician practice administration, and professional satisfaction."

The survey was conducted from July 17 to August 7, 2023, and included physicians who worked at hospitals, health systems, venture capital and private equity firms, health insurance companies, and staffing agencies. All participants spent at least 50% of their time taking care of patients.

Among doctors who said corporate ownership made things worse, the majority (83%) said reduced autonomy in patient care decisions was one of the top negative impacts of ownership changes on patient care. Other negative effects included increased administrative burden (75%) and a shift in focus to financial incentives (72%).

Almost half (45%) reported that ownership changes worsened their relationships with patients. Among this group, 80% said decreased time and communication with patients was a top negative effect of corporate ownership.

Most physicians (63%) reported having substantial clinical autonomy overall, but there were some key areas where their autonomy had been reduced, they said. This included having policies that put restrictions on promoting lower-cost treatments (47%), on out-of-network referrals (61%), and otherwise limit drug prescribing decisions (45%).

In addition, the survey found that two-thirds of physicians felt they had limited involvement in critical management policies at their institutions. About half (52%) didn't know of a formal process to resolve disputes at work.

The majority (59%) also found the EHR documentation procedures at their facility highly burdensome, according to the survey.

Among the 40% of physicians who moved from independent practice to employment, 53% said they made the switch due to government and private insurer reimbursement cuts, and 44% said they would join a union. Still, most (55%) said they were satisfied with their decision to become employees.

"As the structure of medical practice fundamentally changes, healthcare leaders and policymakers have a responsibility to make sure patients and their physicians remain at the center of health care," Kenney said in the press release. "New insights on the employed physician landscape can shape crucial policy decisions in the future."

PAI is a nonprofit organization whose mission is "to advance fair and transparent policies in the health care system to sustain the practice of medicine for the benefit of patients," according to the group's website. As of press time, PAI did not return a 乌鸦传媒 request for comment.

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