Independent physicians essential to solving CA’s healthcare provider shortage

OPINION – Independent physicians and small practice groups are essential healthcare providers in California who contribute to the availability and accessibility of high-quality care in the state. Operating such a practice offers numerous benefits to both patient and physician.

As an independent physician myself, I witness the benefits of independent practice every day. The greatest benefit is the autonomy experienced in all areas of practice. This autonomy allows me to focus on making decisions that are best for my patients, without being forced to jump through the standardized, bureaucratic hoops that exist for physicians who practice in corporate or large group settings. This autonomy extends to my schedule, where I can maximize time spent with patients by creating a schedule that makes me most accessible to them.

Being an independent physician in a rural community has allowed me to support my patients in a greater capacity and make a difference. My practice is the only radiation oncology group in my rural county, also serving two additional adjacent counties. I chose to practice here to enjoy the many outdoor activities, to take care of patients, and to be part of the fabric of the community.

Patients have come to my office’s waiting room, without an appointment, full of panic after receiving troubling, confusing test results, an unintended consequence of the 21st Century Cures Act Final Rule mandating the immediate electronic availability of test results to patients. In these moments, I have often been able to make time to either call them or sit down and analyze their results with them in their moment of need and give them reassurance and advice, instead of forcing them to wait weeks for the next available appointment. If there is an urgent referral, I have the flexibility to arrange my schedule to see them right away. I can do this because I have the autonomy to run my practice to meet the needs of my patients.

By practicing independently, I can design my practice in a way that meaningfully benefits my patients and guards against burnout.

California is facing a physician shortage, exacerbated by physician burnout from the COVID-19 pandemic and employed physicians facing demanding work schedules with long hours, heavy patient loads to meet productivity targets, and administrative tasks in the name of compliance. By practicing independently, I can design my practice in a way that meaningfully benefits my patients and guards against burnout.

For all the benefits that exist with independent practice, there are also many challenges. One of independent practice’s biggest challenges is the ever-increasing mandates on physicians by the government, payors and others. I want to spend my time talking with my patients and running my practice, not fighting with insurance companies, or figuring out how to implement burdensome data reporting mandates.

In addition to the regulatory burdens that exist for independent physicians currently in practice, recent graduates are also shying away from working in independent practices due to the amount of paperwork, rising overhead costs in the face of declining reimbursements, and the issues surrounding insurance and prior authorization. As existing independent physicians retire, they prove difficult to replace, leaving gaps in care for the communities they spent their careers serving.

While the issues physicians in independent practice and small practice groups face are significant, work is already being done to address them. In 2023, the Physician Association of California (PAC) was formed with the sole purpose of representing independent physicians and small practice groups operating in California. PAC’s mission is to protect the viability of small group medical practices and independent physicians while promoting the overall well-being and care of their patients.

Organizations like PAC are necessary to protect our state’s physicians in independent practice and small practice groups so we can continue to deliver high-quality care to our patients in California. I am encouraged by PAC’s mission and look forward to seeing the change we will bring in support of independent physicians and their patients in California.

Dr. Join Luh, FACP, FACR, FASTRO is a Eureka-based radiation oncologist. He has practiced in Humboldt County since 2007 and holds positions in many local and national physician professional organizations.