For years observers have been predicting the impending migration of physicians into direct pay or concierge medicine, where no longer will they have to accept low Medicare and Medicaid reimbursements or haggle with private payers.
Has that time finally arrived?
A recent survey of more than 13,500 physicians found that 6.8% of them would "embrace" direct pay or concierge medicine within the next three years. That includes 9.6% of practice owners, 7.7% of primary care physicians, and 6.4% of specialists, according to the survey conducted by physician recruiters Merritt Hawkins for The Physicians Foundation.
"This is a building crescendo because of a number of things that have happened to physicians or could happen to them," says Mark E. Smith, president of Merritt Hawkins.
"We keep kicking (the Medicare Sustainable Growth Rate funding formula) down the road and the docs' confidence becomes less and less that those chickens will come home to roost," he says.
A fear of major reimbursement cuts is among the top three threats cited by healthcare leaders surveyed in the HealthLeaders Media 2013 Industry Survey.
"There are a lot of unknowns with what will happen with reimbursements and the [Patient Protection and] Affordable Care Act, what it will ultimately cost and what will change. There are big questions about who will be in control of bundled payments. There are a lot of legitimate concerns and unlike a lot of professions physicians have a lot of options."