Over the past three decades, the number of physicians practicing medicine on their own in Western New York and around the nation has declined sharply, while the number in the largest practices has soared, according to the latest data from the American Medical Association.
Between 1983 and 2014, the share of physicians in solo practice fell from 44 percent to 19 percent, while the share working in practices with 25 or more physicians quadrupled over that period, from 5 percent in 1983 to 20 percent in 2014, the AMA reported last July.
The parallel trends have taken hold as younger and midcareer physicians have sought the financial certainty and the scheduling stability that comes with working as an employee in a large practice or at a hospital instead of taking on the burden of starting your own practice, experts say. Financial pressures stemming from lower reimbursements from insurance companies and the federal government, increased regulations on matters such as electronic health records and rising costs of medical malpractice insurance also make running a practice unattractive.
Young doctors come out of medical school trained in how to set a broken bone and diagnose the flu, but not in how to abide by employment law or how to make sure their patients will give them a high score in a customer-experience survey.
For that reason, the University at Buffalo and Roswell Park Cancer Institute hosted an Understanding the Business of Medicine conference last winter. Several participants said they initially sought to open their own practice but changed their mind after realizing how much work was involved.
Large practices have flourished locally, and here is information on a cross-section of them:
Year the group was formed: 2005.
Structure: All practice plans are legally separate business entities but are all UBMD. All physicians are faculty members in the Jacobs School of Medicine and Biomedical Sciences, but UBMD staff and physicians are not UB employees in their roles within UBMD. UBMD is the clinical practice plan of the medical school and salaries and fees for UBMD clinical care are paid by patients and insurance companies directly to UBMD.
Locations: 76, including hospitals and several clinics that UBMD physicians staff within the hospitals. This number soon will increase because 12 of the practice plans will start seeing patients in the Conventus building on the Buffalo Niagara Medical Campus.
Number of physicians in the group: 517
Number of total employees in the group: 1,580 as of last October
Number of physicians in the group 10 years ago: N/A
Highest-ranking employee within the group: Renee Filip, chief operations officer, though each practice plan has its own president/CEO
Specialties: There are 18 practice plans within the UBMD umbrella organization, including UBMD Family Medicine, UBMD Neurology and UBMD Obstetrics-Gynecology. Several have divisions within them, and branches of specialties within those.
2. Buffalo Medical Group
Year the group was formed: 1946
Locations: 23 locations in Erie, Niagara and Chautauqua counties
Number of physicians in the group: 135
Number of total employees in the group: 903
Number of physicians in the group 10 years ago: 112
Highest-wranking employee in the group: CEO Daniel J. Scully
Patients: 252,000 active patients
Specialties: Thirty specialties, including internal medicine, family medicine, oncology, colon/rectal surgery and OB/GYN.
3. General Physician
Year the group was formed: Legally formed in 1994, but began operations in 2009
Locations: 46 in five area counties
Number of physicians in the group: 54
Number of employees in the group: 343
Number of physicians in the group 10 years ago: zero
Highest-ranking employee in the group: Dr. David P. Hughes, owner
Patients: about 100,000
Specialties: Primary care, internal medicine, OB/GYN, cardiology, cardiovascular, geriatrics and behavioral health, among others.
4. Western New York Urology Associates and Cancer Care of WNY
Year the group was formed: 1949 for Western New York Urology Associates, which was purchased, along with Cancer Care of WNY, by Kaleida Health in 2015. The two practices share some back-office operations.
Locations: 11, Cheektowaga, Orchard Park, Cambria, Jamestown, Hamburg, Corfu, Derby, Dunkirk, Springville, Irving and Warsaw
Number of physicians in the group: 30
Number of total employees: 350
Number of physicians 10 years ago: 11
Highest-ranking employee: Dr. K. Kent Chevli, president of Western New York Urology and Cancer Care of WNY.
Specialties: Urology, urogynecology, radiation oncology and pathology.
5. Dent Neurologic Institute
Year the group was formed: 1963
Locations: 3, in Amherst, Orchard Park and Batavia (satellite)
Number of physicians in the group: 25
Number of total employees: 360
Number of physicians 10 years ago: 10
Highest-ranking employee: CEO Joseph Fritz
Patients: 213,000 patients in database
Specialties: Dent Headache Center, Dent Imaging Center, Dent Dizziness & Balance Center, Dent Memory Disorders Center and Dent Sleep Disorders Center.
6. Lifetime Health Medical Group
Year the group was formed: 1978
Locations: 3, Amherst, Buffalo and Hamburg
Number of physicians in the group: 20
Number of total employees: 170
Number of physicians 10 years ago: N/A
Highest-ranking employee: Dr. Stephen H. Cohen, president
Patients: 38,091 active patients
Specialties: Primary care, pediatrics, pharmacy, lab services, dental services, mammography and sports medicine, among others.
Note: Information for Lifetime Health Medical Group is for its locations in the eight counties of Western New York and does not count its locations in the Rochester area.