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Largest Doctors Groups in the United States

Listing of the largest doctors groups in the United States. The list is based on calculations made of data in the NursingHomeDatabase doctors database.

What is a Doctors or Physicians Group?

For many decades, one of the most significant trends in health care has been the movement of doctors or physicians away from individual practice to doctors groups. Doctors or Physicians Groups are simple in concept; it simply means that two or more physicians have agreed to pool their practices to work together as a single business entity in which they share a physical space and all of the overhead required to operate a medical practice. Many physicians groups maintain multiple locations to provide better access to care for patients..

There are many benefits to grouping physicians together as well as some negatives. The primary motivator is that forming a group helps to spread the financial risks of a medical practice and costs while improving access to care for patients.

You may not realize it, but doctors face huge financial risks. They often graduate from medical school with hundreds of thousands of dollars in debt. They are then expected to open an office which means signing and guaranteeing a long term lease. They then have to equip this office by buying equipment and furnishings and hiring several employees with differing skill levels who they are now responsible for. This is a lot of stuff to get right. This problem is even more acute for doctors that have spent the additional time and money to become a specialist. Just imagine if you are a specialist in “Undersea and Hyperbaric Medicine”, how often can you expect to see patients? And what about if your speciality is “Otolaryngology”? (Actually that’s a trick question, Otolaryngologists are Ear, Nose, and Throat doctors. There are lots of ears, noses, and throats around that need constant treatment, so that’s not too bad.)

This simple example misses some of the more difficult problems that doctors face because of the role of insurance and the government in health care, both of which make getting paid more complicated and raise the level of risk if something goes wrong.

(A quick side note. My own anecdotal experience suggests that one thing that is not taught in medical school is how to properly administer an office, certainly not with a view toward customer service. Doctors really need to place a higher priority on finding and hiring good office administrators and then get out of the way so that he or she can do their job properly.)

Two major trends propel the move from individual to group practice. First is that health care is becoming more and more complex. This complexity includes not just the actual treatments and medications that are more diverse but also the interaction between the various players who control the reimbursement system.

The second major trend is the increasing demand for access to health care. The graying of the United States population has meant more and more people are seeking treatment for various maladies and doing so more often. In 2016, more than half of all health care spending in the United States was spent on patients who are 65 years of age or older. The ongoing Covid-19 epidemic has accelerated this drive for access.

Grouping practices allows physicians to achieve economies of scale that are not accessible to them as sole practitioners. These economies work both on the side of the physician where you have multiple doctors but also on the patients. Pooling practices means that each physician now has access to a larger pool of patients.

Here’s a bulleted list of the benefits:

  • Reduced personal financial risk. The cost of the practice and the risk of failure is distributed across the whole organization.
  • Better employee productivity. Multiple practices means improved employee productivity because you do not have to duplicate every role in the practice
  • Added specialized personnel. Because they share overhead doctor groups can also hire more specialized personnel such as Nurse Practitioners and Radiologists that a sole practitioner might not be able to afford. This allows the practice to be more efficient and reach more patients.
  • Lower malpractice costs. Insurance companies would much rather spread the risk of malpractice across multiple providers rather than take the risk that a single practice presents.
  • Negotiating Power. Doctor groups that represent larger patient pools typically can negotiate better reimbursement rates from insurers.
  • More predictable lifestyle. With more doctors, physicians can have more control over their schedule.
  • Better access to and cheaper working capital and equipment financing.
  • Collegiality and opportunities to learn. Being part of a group of physicians allows doctors to learn from each other.
  • Improved Patient Flow. By being part of a group it makes it easier for doctors to be found, referrals are easier, and provider search is simpler.

By having more physicians and by adding specialized personnel, doctor groups can also provide better support for patients. Nurse practitioners can help triage patients and treat patients who do not necessarily need to see a physician making it easier to get an appointment.

Like anything we humans invent, doctors groups do have negative issues too. These include:

  • Reduced autonomy. Partners have to work with each other after all that means that not everything will be under the physician’s control. Vacations will have to be coordinated, work hours will have to be scheduled to fit with others.
  • Have to work with others. Doctors are known as being independent, some of the independence has to be surrendered.
  • Competition. Provider search can be complicated if there are more than one specialist of the same type in a group. For groups of specialists it may result in arguments over to whom patients are directed.
  • Need for consensus. Physician groups can become political.
  • Lower up-side potential. High performing physicians will inevitably have to support the rest of the group meaning that some of the physician’s earning potential can be eclipsed.
  • Increased liability for the actions of others. Liability is always a big problem for physicians. While groups typically are able to negotiate lower malpractice rates, a physician is in part liable for the work that others in the group perform. For multi-speciality groups searching for specific providers can mean engaging physicians that are not as careful or skilled simply to fill out a needed skillset.

What do Physicians Groups Do?

There are two general types of physicians groups, specialized groups and multi-specialty groups. Specialized groups are groups of doctors who all have the same specialty or area of focus. Most doctors groups are specialized groups. Examples of this type of group are: ACM Colon and Rectal Associations, PLLC and Alamo Heights Dermatology PA. These work well for patients who are searching for treatment in a specific area like podiatry.

Multi-speciality groups are formed to provide a broader range of services within one umbrella. These groups can be useful for more general types of care where a patient may need routine consultations. Multi-speciality groups may also be formed to meet the requirements of an insurance payer who will negotiate reimbursement based in part on the group’s ability to keep all treatments under the same roof.

Like everything else in society where there is high demand and a large capital flow, innovators continue to look for opportunities. Private equity is now a big player in the formation, purchasing, and management of large “super groups” of doctors and other medical professionals. Hospitals too are building their own captive doctors groups. Doctors groups are also finding ways to grow beyond what anyone thought possible. The largest doctors groups in our database contain more than 1,000 physicians and medical support staff!

List of Largest Doctors Groups in Each State

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