Many people remember or have seen Norman Rockwell’s iconic art depicting the earnest, white-coated doctor treating a young, nervous kid from the neighborhood. Back then, the small-town doctor was the trusted healer, advisor, therapist and friend.
However, the extended sense of community, trust and familiarity, the occasional house call, and the close proximity of our doctor to our home are becoming things of the past.
It appears that we may have finally reached the twilight of that age, where the independent physician is nearly extinct, and that is not a good thing for any of us.
Not so long ago there was a prevalence of independent physicians’ offices throughout the state. Just go back 30 years and parents could find a local pediatrician, perhaps housed in a converted historic house, where they could bring their children.
Where have these small-town, local, independent doctors gone? They have departed to larger doctors’ groups, and even larger hospitals.
In a survey by Accenture, the percentage of U.S. physicians who practice outside a hospital, clinic or large medical group fell from 57% to 39% from 2000 to 2012.
So why has this migration in the field of medicine taken place? There are a number of reasons.
Of those leaving independent practice, 87% cited the cost of doing business, 61% said managed care did them in, while half pointed to the cost of modern electronic health records.
A poll that was conducted by Sermo, a physicians’ web resource and community, found that physicians closed their solo practices due to the increased overhead costs, high malpractice-insurance costs, and dwindling reimbursement rates.
Certainly, the state of Connecticut has done its fair share to spin webs of bureaucratic red tape to ensnare the business side of medicine, while heavily regulating and mandating insurance carriers that has increased costs all around. While this trend is national, Connecticut stands out in its excessive regulatory environment.
In our state, as smaller independent doctors’ offices are swallowed by clinics and hospitals, smaller hospitals and nonprofit hospitals are being absorbed by larger out-of-state provider networks. The community hospital is now also endangered.
Under Gov. Dannel P. Malloy, Connecticut has walked back its commitment to our local hospitals. With the help of an obliging Democratic legislature, the governor instituted a damaging hospital tax, which has cost jobs, increased healthcare costs and reduced access. Represented by the governor as a temporary measure in 2011, it has been sustained.
The governor’s budget chief said the reason the state drains up to $600 million from our statewide hospital systems is simple: “ It’s where the money is.”
While the days of the independent physician may be numbered, there are some important things the legislature should do to roll back this harmful trend.
First would be the elimination of the hospital tax, which is felt so disproportionally by our community hospitals. Next would be to restore the cuts to community hospitals that the governor and legislature have made.
It is time for the legislature to stop treating our community hospitals as cash cows, and reverse the damage being done to our system of providers. Unless action is taken quickly, it will be too late.
State Rep. Jason Perillo is serving his fifth term representing the 113th District, which includes most of Shelton. He is the former chief of Shelton’s Echo Hose Ambulance.