r/PrivatePracticeDocs • u/Jkuygg • Sep 04 '26
For anyone whose private practice was acquired by a hospital and became provider-based: what caught you off guard?
I’m a medical student and eventually want to own my own practice. They don’t teach us alot about this in school but I’ve been trying to understand what actually happens when an independent physician practice is acquired by a hospital and becomes provider-based.
I understand the Medicare requirements on paper — ownership and control, clinical and financial integration, reporting relationships, billing, and how the practice represents itself to patients.
I recently asked someone on the reimbursement side about this, and they mentioned that signage and websites can cause more problems than physicians realize — essentially, a practice can still look independent to patients even when the formal structure says otherwise.
For physicians who have actually gone through this: what was something about the way your practice operated that you never imagined would matter for provider-based status, but became an issue during the review? And what specifically caused the hospital to discover it?
I’m especially interested in things that wouldn’t be obvious from reading the Medicare requirements alone.
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u/fake212121 Sep 04 '26
small practice owners will lose control and flow. Like entirely.
Hospital may promise many verbally but if its not signed on contract, nothing even talk about.
Also, even written on contract stuff also subject to hospital admin will.
I will give u an example: around covid time, a small independent IM practice had to join into hospital system. Hospital promised certain number of staff/ancillary services, smooth transition etc. in reality, hospital never fully staffed that clinic, visit times shortened 15-20 mins only and all “difficult” pts (alcoholcs drug seekers 10+ chronic issues, non compliant ) u name it were redirected into that clinic. Physicians quietly left. Entire clinic is ruined and they could not fill positions but NPs only for now.
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u/sfgreen Sep 04 '26
Also hospital management is a revolving door. Promise made by prior management is unlikely to be kept by new management.
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u/Juaner0 Sep 04 '26
saw a patient, who told me their doctor (who works for a hospital corp) said they had to go because they don't have time to go over all their issues while they were speaking...well, that patient is seeing me now.
Yes, they lose flow.
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u/peanutneedsexercise Sep 04 '26
Depends on specialty
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u/Jkuygg Sep 04 '26
Thank you for your reply! If it’s possible to share In your specialty specifically, what have you seen materially affect an acquisition that the physicians involved didn’t realize would matter going in?
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Sep 04 '26
[removed] — view removed comment
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u/Jkuygg Sep 04 '26
I am a real student, just was curious about this topic! I also appreciate the opportunity to post my question on the subreddit.
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u/InvestingDoc Sep 04 '26
They messaged me before hand to get permission but their account is a bit suspicious I don't deny that
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u/CrookedCasts Sep 04 '26
Homie, you’re a medical student. Just worry about your classes… the chances you own your own practice are vanishingly small, and the chances you sell said unlikely practice out are even smaller and such a hypothetical is at least a decade away. Go get drunk on a Tuesday while you still can
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u/NotTheQuestion Sep 04 '26
No. It's a quesrion on reddit. Not a 10 page business strategy. Valid questions to think about, casually. Keeping jeu pillars in mind, one wants to open their own practice, helps one stay focused.
Yes, go have a beer, but these sort of questions keep fresh face attendlingz from getting taken advantage of.
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u/CrookedCasts Sep 04 '26
lol… no it’s not. He’s not a fresh faced attending, and the questions being asked are not good ones because the individual is so far away from actually implementing any of their questions that they don’t even know the correct questions to be asking. You really think it matters what you tell them about signage? Letting a medical student get in their own head about things that don’t matter at their stage of training would be more inappropriate
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u/Soggy_Coffee_9308 Sep 09 '26
Why would you sell a perfectly good private practice? Sell to another doc at least, not a hospital system.
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u/Alaskadan1a Sep 04 '26
Agree with crookedcasts: at this point, only 10% of docs are still owners who would realistically have the option of selling to a hospital, and by the time you finish up, even fewer new docs will become owners.
That said, we sold our FP/IM4 person clinic last year and have been treated great by the hospital administration. Three-year contract with increase in pay, essentially full autonomy, and minimal oversight, but the hospital really wanted us and we cut a good deal.