I didn’t need the Wall Street Journal to tell that the days of “private practice” are numbered.  According to recent numbers, fewer and fewer medical practices are under the ownership of physicians.  Even in my corner of the economically secure State of Texas, small practices are folding faster than beach chairs at high tide. It is the end of private practice.

I was driven out of private practice in 2004 by rising malpractice premiums and plummeting reimbursement.  In Texas at the time the trial attorneys ran the place and medmal insurance carriers simply couldn’t keep up with the greed.

Medical practices are just too expensive to run and the services that physicians provide are dangerously undervalued.  You do the math.  Sure it’s a complicated issue.  But the end result is institutionally employed doctors with institutional pay and the risk of institutional service.

Of course we need to contain costs.  And I know, it’s about the patient and nothing else.  And all doctors are filthy rich.  Of course they are.

Self-annointed experts blather about doctors, medical economics, and solutions.  Government bean counters and consultants think they’ve got it figured out.  They have no idea what we do, where we’ve been, or the staggering self-sacrifice necessary to manage a panel of chronically ill patients.

I spent the best years of my life working 15-hour days as a scut monkey training to get where I am.  But the next generation will be more judicious.  As society sees what doctors do as a commodity, society will see commodity doctors.

The plight of the physician in America is now considered dead last. But don’t cry for me.  Cry for your self. It’s the end of private practice.