MERIDIAN - As many doctors decide to ditch their own shingle and go to big hospitals, a group of nearly 200 Idaho doctors is banding together to promote independent physicians.

"Independent Doctors of Idaho" (IDID) started as a response to what the organization calls an "unprecedented number of physicians in the Treasure Valley and throughout Idaho becoming employees of large hospital systems", like Saint Alphonsus or St. Luke's.

Some of the independent doctors say they're at a disadvantage from a marketing standpoint because they don't have hospital billboards, big ads, or automatic networking within a system. The organization's goal is to let patients know about alternatives in health care providers through independents.

"The message is that it is doable and favorable to remain independent," Dr. Joe Williams, Idaho Urologic Institute, said.

Dr. Williams, an IDID board member, says medical administration has been cyclical through the years, with doctors shifting to and away from being independent.

"The trend toward hospitals buying out physician practices began roughly ten to twelve years ago when federal payer payment systems fostered the ability of hospitals to consolidate control and income," Williams said.

Williams says the current shift away from independent doctors likely because of federal health care reform and Medicare and Medicaid record keeping requirements.

"That has mounted a lot of responsibilities onto the administrations of individual offices, and a lot of physicians look at that as being onerous in this time frame," Williams said. "Especially a busy practitioner in an isolated area, they may not have time to do that or feel like they have the resources. One of the things Independent Doctors of Idaho wants to do is help provide information to folks in those situations so they can get the support they need."

Williams sees the trend of doctors joining hospital systems continuing, but he thinks after the dust of reform change settles, that will change again.

Independent doctors believe their system offers more patient choices in terms of where to get care, treatment and testing, without being specifically tied to one particular hospital or another specialist.

"Being able to guide our own destiny day to day is a very nice and freeing aspect of being independent. It's one of the reasons I went into medicine, is so I could run my own business and put forth a product unfettered by a large administration," Williams said.

Williams believes independents have become more attractive to some doctors and patients recently... Particularly in places where hospital turf wars are being waged, like could been seen in the recent Saint Alphonsus v. St. Luke's antitrust lawsuit over the acquisition of physician-owned Saltzer Medical.

"(They) just don't want to get involved in those processes," Williams said.

In terms of other benefits, Williams believes the independent model can be more cost-effective. He says local payer numbers have indicated prices at independents can be 50-60 percent cheaper than employed physician offices.

"We own our buildings, we own our practices, we pay our overhead; therefore, the onus is on us to help make it a valuable experience for patients. We're able to control our costs," Williams said.

On the other hand, many doctors say they've joined hospitals for a variety of benefits they see in being under a big umbrella. As Williams said, some small practice doctors have found benefit in getting help with administrative aspects of health care. Some rural offices said they couldn't afford new equipment to deal with new office reporting mandates.

Spokesmen from both Saint Alphonsus and St. Luke's say they support independents as other choices for patients. In fact, many independent doctors, like Williams, do see some patients at the hospitals and are part of network or insurance groups associated with those systems.

For example, Williams is a member of the Saint Alphonsus Health Alliance, which coordinates care across provider with things like access to medical records, specialists and technology. Saint Alphonsus says over 75 percent of the alliance is independent doctors.

St. Luke's Select Health insurance plan incorporates some independent doctors, like Williams. Additionally, both hospitals have independent doctors that have "privilege" to see patients.

As far as snapping up independent doctors, St. Luke's says it has a policy against recruiting and says doctors approach the hospital.

Saint Alphonsus says it doesn't actively recruit but does look for independent physicians if they have gaps in specialties, like general practice or dermatology.

To learn more about Independent Doctors of Idaho and to find physicians in the group, click here.

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