To the Editor:
If you’ve recently tried to make a medical appointment, you’ve probably noticed it’s harder to find an available doctor – especially one who knows you personally and isn’t part of a giant health system. That’s because independent physicians are disappearing.
Fifteen years ago, nearly 70% of doctors in America ran their own practices. Today, fewer than 25% do. This isn’t just a professional shift, it’s a crisis for patients.
Independent practices offer personalized care, continuity and lower costs. But we’re being squeezed out by a system that rewards consolidation and bureaucracy over direct care. Medicare and insurers often pay hospitals more than private doctors for the exact same service. Layers of administrative red tape and billing requirements fall hardest on small offices.
Meanwhile, young physicians graduate with little training in how to practice outside of large systems.
Patients suffer the consequences – longer wait times, higher bills and fewer choices.
If we want to preserve personalized, accessible, community-rooted care, we need real reform:
1. End payment discrimination with site-neutral reimbursements.
2. Simplify the compliance burdens for small practices.
3. Encourage medical schools to teach independent practice pathways.
4. Enforce antitrust laws against monopolistic health-care systems.
5. End precertification and prior authorization requirements for testing and medications.
Why End Precertification and Authorization? Precertification and prior authorization processes required by insurance companies for medical tests and prescriptions are another key obstacle that disproportionately affect independent practices.
These requirements create significant delays in care, increase administrative burdens and ultimately compromise patient outcomes. A doctor who knows the patient well should not have to spend hours filling out forms or waiting for approval from an insurer to provide necessary tests or treatments.
When doctors are forced to navigate these processes, it not only wastes valuable time but also increases patient costs and frustrates efforts to provide timely care.
Ending these administrative hoops would allow doctors to focus on what they do best: treating their patients. It would speed up access to tests, medications and therapies, empowering physicians to make decisions based on the needs of their patients rather than the demands of insurance companies.
If we truly want to preserve independent practices and ensure that future generations have access to the personalized care they deserve, this must be part of the solution.
We still exist – doctors who run our own practices, treat our neighbors and know our patients by name. But we need help.
Let’s make sure that future generations still have the freedom to choose a doctor, not just a corporate network.
Dr. Scott Tzorfas
Board-certified neurologist
Cape May Court House
