Page 4 - Mid Valley Times 3-10-22 E-Edition

Founded March 26, 1891, in a two-story building on the corner of 11th and F streets, by A.S. Jones
Guest Column
Will the independent medical practice become extinct in America?
By Sally C. Pipes
Guest columnist
Facing declining revenue prospects, physicians are shuttering their private, independent practices to join up with larger hospitals that have near-monopolies on care in the regions they serve.
This trend is depressing news for Americans. Fur- ther concentration of market power in these health sys- tems ultimately results in less personalized care for patients -- and higher overall costs.
Over the past 20 years, Medicare physician pay has increased 11 percent. The overhead costs of operating an independent medical practice, on the other hand, has jumped nearly 40 percent. Factoring in inflation, Medi- care physician pay has dropped roughly 20 percent in the past two decades. Clearly, those who remain in the sector aren't in it for the money.
For many independent physicians, not even a mir- acle could make this business model sustainable. Per- haps that's why 2020 marked the first year independent physicians accounted for fewer than half of all practic- ing doctors in the U.S., according to a survey from the American Medical Association.
Physicians closing up shop short of retirement typically go to work at larger hospital systems, many of which enjoy a monopoly on healthcare services in their catchment area. According to the AMA report, the number of physicians employed at hospitals increased roughly 50 percent between 2012 and 2020.
In addition to poaching physicians, hospital systems are acquiring private practices outright. AMA data show that between 2012 and 2020, the share of doctors working at a private practice that was at least partially owned by a larger hospital system grew nearly 40 per- cent.
And as the AMA survey notes, the majority of doc- tors employed by hospitals are under the age of 40. That suggests this trend "will continue over the long term."
Many younger doctors prefer the more regular hours that hospitals offer, as well as a fixed salary. Private practice may be less predictable -- in terms of both workload and pay.
Nevertheless, the shift away from private, indepen- dent care towards corporate mega-providers should alarm patients and policymakers.
For starters, care will become more expensive as hospitals expand their regional monopolies. As health systems grow, they gain undue leverage with insurance providers to propose service-price hikes. One study in the Journal of Health Economics found that prices for physician services rose nearly 15% at practices ac- quired by hospitals between 2007 and 2013.
Without competition from independent practices, hospitals have little need to keep a lid on prices. They can charge patients and their insurers effectively what- ever they want to.
Diminishing quality of care is another concern. Physician pay within a hospital system is determined in part by how many patients each doctor can treat, assembly-line style. So much for patient-centered care.
We're witnessing a historic shift in the practice of medicine in the United States. And it isn't an edifying spectacle, especially if you're a patient in need of medi- cal care that is humane, attentive, and not delivered on a conveyor belt.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Re- search Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All" (Encounter 2020). Follow her on Twitter @sal- lypipes.
NorCal soccer match incidents a disturbing trend in this day and age
Fred Hall — Publisher Emeritus Jon Earnest — Editor
Dick Sheppard — Editor Emeritus
Thursday, March 10, 2022 | A4 | Mid Valley TiMes Editorial & Opinions
Serving the Readers of the Reedley Exponent, Dimuba Sentinel and Sanger Herald.
A Mid Valley Publishing Newspaper
As we celebrate highly suc- cessful seasons for the Reedley High and Sanger High boys soccer programs — as well as the Sanger High girls — it's un- fortunate that a sad and, frank- ly, pathetic situation has arisen in the past week on the "pitch" during matches up in Northern California.
There were two incidents, one involving the Apache boys and the other involving Bu- chanan High's girls, where actions reflected the worst of human behavior. Racially and ethnically insensitive com- ments and taunts from people associated with De La Salle High (whose boys team de- feated Sanger) and Oak Ridge High (involving the Buchanan girls) are disheartening to hear in this day and age.
In Sanger's case, it appar- ently involved either parents and students, and possibly a press box occupant, who made disparaging comments about the Apaches' predominantly Latino makeup of their squad. Maybe even more disturbing was the recording of a person making monkey sounds when an African American girl from Buchanan took a penalty shot during an overtime special kicks shootout. It's hard to be- lieve this type of behavior oc- curs in this day and age, espe- cially given the emphasis on in- clusion, tolerance and race and
gender relations in what's been a racially-charged past decade. Rebecca Brutlag, media re- lations spokesperson with the California Interscholastic Fed- eration, told the Fresno Bee on March 7 that the organization “takes allegations of unsports- manlike behavior seriously” but would not comment fur- ther. All schools involved in the incidents apparently are conducting separate investiga- tions, and the CIF condemned
any of the alleged conduct.
Of course, the real issue is just what exactly will be done if all these actions are fully substantiated. Good sportsman- ship always has been a bit of an issue in high school and college athletics — perhaps it's a natu- ral offshoot of poor behavior at the professional level by a select number of high-profile athletes – but last week's ac- tions have gone beyond mere poor conduct and should have some definite consequences. Just how severe depends on the actions of De La Salle and Oak Ridge administrators in confronting the problem. What we saw has no place in sports at any level, and in school edu-
cation in general.
That said, we have to re-
turn to praising great seasons by both Reedley and Sanger. It was a milestone campaign for the Pirates, who went from eighth seed out of eight teams
to capture the
prestigious and
top competitive
Central Sec-
tion Division
I field. Add a
NorCal playoff
victory, and Pi-
rates players,
coaches and fans cane truly be proud.
The same goes for Sanger, which captured yet another County Metro Athletic Con- ference title and reached the Division I title game in their move up this fall to the pre- mier bracket. The Apaches have turned in three straight momentous seasons, includ- ing the 2020 Northern Califor- nia Division II title. We also have to salute and praise the Sanger girls, who followed up last year's Division II section runner-up finish in 2020 with a section title this winter.
•••
Residents in the Mid Valley
Times region are invited and welcomed to attend a memorial service for our late publisher, Fred Hall, on Friday, March 18, at 1 p.m. at the Reedley Com- munity Center's California Room. Mid Valley Publishing wishes to remember and com- memorate his life and 27-year leadership of the company.
Jon Earnest is news-sports editor for The Times.
Any resource taken for granted is a resource at risk of being lost. That is why the Cal- ifornia Groundwater Associa- tion, The Groundwater Founda- tion, and the National Ground Water Association will be join- ing hundreds of organizations across the country in celebrat- ing National Groundwater Awareness Week, March 6-12. National Groundwater Aware- ness Week, now in its 23rd year, is an annual week of aware- ness, education, and advocacy focusing on one of the nation’s most precious resources.
California depends on groundwater for nearly 46 per-
cent of its public water. It also provides more than 1.4 million residents with safe and clean water through their private water wells. The United States uses 79.6 billion gallons per day of fresh groundwater for public supply, private supply, irrigation, livestock, manufac- turing, mining, thermoelectric power, and other purposes.
For those California resi- dents who rely on private wa- ter wells, we encourage you to use Groundwater Awareness Week to test, tend, and treat your private water system. An annual inspection of your well and its water can not only save
you thousands of dollars in po- tential damages but can also protect the health of your fam- ily.
To find a certified water well contractor in your area, you can visit: wellowner.org.
Whether it’s writing a letter to your representative, posting groundwater facts on social media, or having your own wa- ter supply tested and treated, please remember to take time this week and help protect groundwater in California!
Dave Schulenberg Executive Director,California Groundwater Association
Letters from readers
QUOTE
“The spirit of resistance to government is so valuable on certain occasions, that I wish it always to be kept alive.”
— Thomas Jefferson (1743-1826)
Jon Earnest
Letters Policy
MID VALLEY TIMES invites letters from the public on any topic of local relevance. We reserve the right to edit letters for clarity or brevity, and we reserve the right to NOT publish them if they could be deemed libelous or profane. Letters should
be 350 words or less, and bear the author's name, address, and phone number. Letters can be mailed, emailed, submitted via our website, or personally delivered to: Mid Valley Times, 1130 G St, Reedley CA 93654.
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