According to Jeff Goldsmith, University of Virginia, Public Health Science Professor, the trend of doctors who participate in independent medical practices to either close their practices or become part of hospital practices is accelerating. Hospitals receive a higher reimbursement rate for the same service, if performed by an independent physician. Though the overhead for a hospital is generally higher than the overhead for an independent practice, this burden is no longer borne by the doctor. They become an employee of the hospital and, thus, are relieved of their administrative burden.
The move of independent doctors to hospitals poses two problems. Cost are higher because we pay more for the same service. The other problem is more subtle. Once doctors become employees of large institutions, they lose their ability to control how they practice medicine. Hospitals set standards, including mandating the number of patients a doctor must see in an hour. Once the doctor loses his independence and the patients disperse, it is a difficult task to rebuild a practice once the practice has been dismantled.