A quarter of CT doctors work for big hospitals. Is that good for patients?

In 1999, Kristie Schmidt, an internal medicine physician, opened a practice in Millerton, N.Y., just a mile from the Connecticut border.

The office was located in a cozy, refurbished barn. Sharon Hospital provided her with a loan, which it eventually forgave, to help her get up and running. Her small staff included her husband at the time, who managed the billing, and a nurse who doubled as the secretary and knew every patient by name.

But after about a decade, the challenges of running a small business came to a head.

“It became increasingly difficult to make an adequate living,” she said.

So in 2012, Schmidt joined a large group practice called Mid Hudson Medical Group. Under the agreement, Mid Hudson got a cut of what she made from patient visits. But, because of its size, the company was able to negotiate higher rates from insurers, so Schmidt still took home more than she did when practicing independently. Plus, Mid Hudson took over back-office tasks, like billing, that were taking up time and energy.

“My income went up some, and the hassle factor went way down,” said Schmidt. “It was a relief to not have to go broke.”

As the health care industry becomes more and more concentrated, some small private practices like Schmidt’s find it difficult to compete with big health care systems. So, instead, they’re joining them.

As of January, hospitals owned 26 percent of physician practices nationwide, up from 14 percent a decade ago. An additional 27 percent of practices were owned by a corporation, such as a health insurer or a private equity firm, leaving fewer than half of physician practices under independent ownership.

But, to the patient, does it really matter whether practices are owned independently or by a health system?

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