Sep 4, 2019 • Longeviti

When Hospitals Attack – Surviving 2020

The “land grab” over the control of private medical practices continues

At first, it was the hospitals. They went on a buying spree in the ’90s only to find that they had “overpaid” for practices and lost money. That was Round One.

In the last decade, they’ve tried once more with greater success, but that success came largely at the expense of their new physician-employees.

But the hospitals haven’t finished. Seeing the rise in the appeal of Urgent Care, they have opened their own and are quite open about their intention to operate them as “loss leaders.”

By mid- 2017, less than ½ of all physicians were “independent.”

It’s not only the hospitals

Also purchasing medical practices are the insurance companies… who are maneuvering to become hospitals! 

More recently, Private Equity has entered the fray, buying up everything from primary care to orthopedic and oncology practices. Their goal is to “package” them up for later sale to the insurance companies and the hospitals.

“When Elephants Fight, it’s the Grass that Suffers.”

                                                                                          Swahili Proverb

Ironically, it’s not the physicians who have remained in private practice that are the “grass” in this analogy. The ”grass” is the hospital physician-employees who traded away their practices to the hospitals for a few promises and little to no long term security.


The Competition

  • The hospitals with nearly limitless resources to support large scale marketing
  • Urgent Cares that offer significant convenience and transparent pricing
  • Hospital-controlled Urgent Cares run as “loss leaders.”


“You can be sure of succeeding in your attacks if you only attack places which are undefended. If quick, I survive, If not quick, I am lost. This is death.”

Sun Tzu

That’s a bit dramatic, but it illustrates well the challenges and opportunities facing private practice primary care.

While a private practice could attempt to equal the convenience of an Urgent Care, that practice would become an Urgent Care. Worse yet, it would be an Urgent Care without the competition’s resources.

Further, no individual practice can expect to compete with the marketing power of the hospital.

For a private practice to compete successfully, it must move quickly and avoid competing where hospitals and the UC’s have the advantage.

The Core Strength of the Private Practice

Well established private practices have long-standing relationships with their patients based on trust and the physicians’ comprehensive knowledge of their patients and their conditions. This invaluable relationship makes possible the high standard and continuity of care, these fortunate patients receive.

Urgent Care and “retail-oriented,” hospital-based primary care is simply not structured to deliver this standard of care. That is their weakness and there are multiple ways to exploit it.

There is still time enough time to adapt… but:   

The political uncertainty over the future of healthcare and the competitive pressure from the better-resourced competition can only increase.

Acting now to enhance the health of your private practice by building upon its very considerable advantages is simply good medicine.

Learn the “all-weather” strategies used by successful private primary care and family medicine practices to improve profits and enhance physician satisfaction


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