What’s Up, Doc?

Okay, this one seemed a little out of sync for me: doctors would apparently be employees than free agents. Or at least that’s what the New York Times says, in this article that was splashed across the front of the  business page.

According to the Medical Group Management Association, in 2005 about two-thirds of medical practices were physician owned (and it had been that way for years). By  2008, the share had dipped to less than 50 percent.

Doctors are ditching the small busines thing and choosing to be employees. What gives?

Well, for one thing it has gotten more expensive to be a self-employed doctor. These days, you have to think about moving to an electronic health record system, which can be a pricey undertaking for a small business (which is essentially what a doctor in private practice is operating). Add to that the whole lawsuit/fee structure mess and you have a disincentive to set up shop on your own.

Then again, you’d think that younger doctors would eschew the corporate model. These days, newly minted doctors are Gen Yers, and they have been blathering on for years about how they want their workplaces to look and feel. More freedom, more creativity and all that.

Surely the best way to get the kind of workplace you want would be just to run it yourself?

Theoretically, if you’re the boss you set your own hours and your own policies and all that. You’d think that those gotta-be-me Gen Y doctors would gravitate to the model.

Maybe not, particularly following the recession.

After all, it was business owners who got burned the most during the downturn (arguably, anyway).  To run a business means assuming a risk, and dealing with those risks when the economy turns down.  And, in the case of being part of a medical practice, you have to assume a bunch of debt and set up shop or buy your way in.

So for this second wave of Gen Y doctors (figure that Gen Y started around 1980 or just before and the oldest, or the first wavers are now in their 30s) it may seem like a better idea to just be on payroll and let someone else deal with collecting the fees and all that.

After all, as an employee the worst thing that can happen to you is that you lose your job.

We’ll get a better idea on all that when we have the data for 2009 and 2010 (according to the National Bureau of Economic Research, who calls these things,  the recession started in December 200, although that’s an educated guess anyway and lots of industries started to turn down before that).

This may just be a doctor thing, and you may not see it reflected in other occupations, but it is something I want to watch.

This is a post-recession world, and those corporations everyone loves to hate just may look like more fun than they did before.