As solo and small group urology practices seek refuge from growing regulatory and economic burdens by joining bigger entities, urologists accustomed to calling the shots are wondering if autonomy is dead. Experts with the larger groups and health systems providing alternative models and much-needed economies of scale say autonomy, or maintaining control of how a urologist practices, isn’t gone entirely, but it is different.
Urologists might be happy to relinquish control of burdensome administrative tasks, including keeping up with evolving government regulations and payer demands. They’re often relieved to let a large group or health system administrator worry about making ends meet.
The struggles for many arise when they lose control of their ability to make all the decisions about how to care for individual patients, have to go through red tape to hire new staff or buy equipment, or can’t make choices about what hours they work or the amount of call they take.
Autonomy is a big concern among physicians, according to attorney Curt Chase, JD, chair of the health care, life sciences, and education business unit at Husch Blackwell in Kansas City, MO.
“It’s probably one of the biggest challenges of any transaction we work on—maintaining that level of autonomy on the issues that really matter,” said Chase, who represents both hospitals and physicians.