From WSJopinion: Consolidation is wiping out private practices and making medical care costlier and worse, writes DevorahCGoldman
Since the start of the Covid-19 pandemic, my dad’s rheumatology practice has been flooded with new patients, including many from far-flung cities or out of state. This isn’t thanks to a new marketing strategy or to a notable spike in arthritis sufferers. One elderly woman who had traveled from New Jersey to my father’s Brooklyn, N.Y., office explained that many practices near her home had closed.
. When she and her colleagues wanted to add new services for their patients, she wrote, they “didn’t have to go through 27 hospital committees and ask permission from a bunch of vice presidents for various things.” For a long time, the AMA and other medical establishments such as the American Association of Medical Colleges quietly celebrated the turn away from small medicine. They assumed that larger, more consolidated health systems would also be more efficient. On the whole, this has not turned out to be the case.
Bureaucratic structures often suffer from inflexibility. Throughout the Covid-19 pandemic, medical bureaucracies at the national level have struggled to adapt to sudden changes in medical information in the way that frontline physicians can. Doctors must operate with a clear sense that they are serving the patients in front of them, not the government, data-collection systems, insurance companies or hospital directors.
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