Solo Practice Challenges

• Declining reimbursement
• Shrinking insurance provider networks
• Increased regulatory requirements
• Competition for patient base

Impact of the Affordable Care Act

The increase in regulatory requirements is especially onerous for solo and small practices, which frequently lack the access to capital necessary to implement electronic medical record systems, meet mandatory quality reporting. Escalating overhead costs, particularly for medical liability insurance and staff salaries, and the difficulty in recruiting new surgeons to the practice are other challenges.

Practice setting

In 2014, the most popular practice setting was a group private practice (35 percent), followed by academic practice (16 percent), solo private practice (15 percent), hospital (15 percent) and multispecialty group private practice (10 percent). Locum Tenens, military, HMO, public institution, and other accounted for the remaining 9 percent. The results showed that orthopaedic surgeons were leaving solo and group private practice settings and moving to hospital centers and academic practice.