The fight against the pressures facing independent primary care practices can take many forms. For some, it has meant joining forces with other practices to attain the benefits that come with size without sacrificing their day-to-day autonomy. Others are taking a different route—minimizing the bureaucratic obstacles to practicing medicine by adopting direct pay practice models.
Some physicians are finding that running two separate practices—or a hybrid concierge practice that includes traditional fee-for-service—can be a smart economic model. Attracting patients willing to pay extra for conveniences or more extensive care can ease the financial strain of treating patients for whom third-party reimbursements are declining.