Guest writer

OPINION | R. JONATHAN HENDERSON: For independence

Competition drives higher quality


We have all experienced the impact of large hospital systems that consume entire independent physician practices, turning them into economic engines rather than epicenters of patient-centered care. In 2020, independent physicians accounted for less than half of all practicing doctors for the first time in U.S. history.

As a practicing urologist, I experienced firsthand the enormous pressures of rising competition and operating costs. So why do some physicians choose to remain independent?

Despite promotional claims from gargantuan health-care systems, when hospitals acquire or merge with private practices, it rarely results in improved access to care, higher-quality care or reduced prices. Decades of research suggest that most hospital mergers and acquisitions reduce competition and drive costs upward.

Americans are aware of these consequences--a recent national survey found 50 percent of patients believe continued hospital consolidation will affect quality and access to care. The same survey found that patients preferred greater transparency of pricing information, with 51 percent saying they would prefer to shop around for the best prices for recommended tests or services. Hardworking people want more choices, better access, transparent pricing information and more affordable options.

As hospitals continue to monopolize the health-care marketplace, patients increasingly lose autonomy over where they may seek care. High-quality care cannot be rendered through an anti-competitive system focused on increasing profits rather than prioritizing patient needs.

This continued shift in the health-care environment will mark a sharp downturn in equitable, accessible, and quality care unless policymakers choose to act to ensure a marketplace in which hospital systems and independent physicians can compete to provide the highest quality care to Americans. For example, when reviewing hospital mergers and acquisitions, there is room for the Federal Trade Commission to consider not only prices, but also access to care, especially for vulnerable populations like those not covered by commercial insurance.

As president of Large Urology Group Practice Association (LUGPA), the largest urology trade association in the United States, I tirelessly advocate for all patients to have access to transparent prices, the right to choose their physician and the ability to share in decision-making with their physicians. This respect for patients is something that is deeply ingrained in independent urology practice.

When my previous urology practice merged with a hospital system, I knew it was time for a change for me to help protect the value of independent practice and do the most good for as many patients as possible. For this reason, I chose to move to Little Rock and work with provider-owned Arkansas Urology, which treats approximately 110,000 patients each year across multiple facilities.

Little Rock currently stands as an example of a marketplace in which competition encourages high-quality care. On behalf of my colleagues and patients, indeed every patient in America, I will continue to fight to ensure independent practices always remain an option for all.


Dr. R. Jonathan Henderson, M.D., is president of LUGPA and a physician at Arkansas Urology.


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