I took my eye off the ball for just a little while, and guess what happened? When I looked again, I discovered that familiar solo practitioner, or small group physician medical practices, are on the verge of disappearing. Going the way of the dinosaur.

At least, that's what the pundits are saying.

In a newly-published, nifty newsletter I received today, STAT Monthly, I read:

“Primary care physicians and other specialists will continue to be the target of acquisitions by larger health and hospital systems. Physicians will begin to transition to a more consumer-based patient orientation model (i.e. concierge medicine, cash-for-services, retail) in order to replace lower reimbursements, or opt out of third-party reimbursement models entirely. Or alternatively, these physicians will shift to become an employee of a larger system.”

Now, I see this once, and I figure this is someone just spouting off. But these observations have been cropping up repeatedly in the "healthcare trends” literature for the last couple of months, so I have to believe that there may be some truth to these predictions.

I'm becoming convinced that it's time to pull your head out of the sand if you are: a) not on the verge of retirement; b) not independently wealthy; or c) not fresh out of medical school and pre-programmed to understand that the future of medical practice is different.

As a practicing physician, it appears you're facing a major fork in the road. Either you will seek a Sugar Daddy with pockets deep enough to buy, or somehow take over, your medical practice -- described in the STAT Monthly article as "complex employment arrangements, or some form of asset lease or acquisition as opposed to an outright purchase" -- or you will bravely go it alone and eschew all forms of payment other than cold, hard cash or shiny plastic!

This has the makings of a Morton's fork dilemma for the many of you who just want to be left alone to practice medicine -- and do it your way!

If you're a physician with an entrepreneurial go-it-alone spirit, perhaps this is the time to declare your independence from all third-party payers and go the concierge-medicine route -- or maybe just the cash-only practice.

If you're a risk-averse type, saddled with a huge mortgage, three kids in private school, and two car payments, now is the time to start looking around for a handy "Big Daddy" buyer, or at least someone to rescue you from the loneliness of being one of the last remaining twosies or threesies traditional medical groups!

What are you seeing on your horizon?